Hints for an improved treatment of Remittent Fever and Dysentery, by E. Hare, Assistant Surgeon, Irregular Cavalry, Bengal Medical Service. Delhi Press, pp. 36.

THE author of this practical little work has departed from the usual custom of Authors to make as much as reasonably may be out of their stuff. Instead of wearying himself to make long what his readers would have to weary themselves to make short; Mr. Hare has condensed into as small a compass as possible, material which his readers will amplify and illustrate with cases from memory as they go along. He tells us in the preface that he cannot afford the risk of publishing an expensive work, and it is obvious he has but one sincere design in appearing in print at all, viz.. modestly to suggest his views to the profession on a practical subject on which he has had particularly favorable opportunities of experimenting; under these circumstances we feel the more bound to assist him in making the result of his observations known to our readers. The safe and rational treatment of Tropical Fevers and Dysentery is not a subject interesting to the medical profession exclusively. Without invading the province of the faculty which educated people are particularly averse to do, and which only the illiterate, rude, and ignorant commonly attempt, it is very desirable for those who are called to travel in jungles, alone, and remote from aid, to place themselves in possession of principles to guide them in cases of emergency affecting their own life and the lives of their dependents. Hence we need not make any apology for extending our notice of Mr. Hare's pamphlet beyond the limits we would commonly assign to a medical pamphlet. We observe the new Calcutta Medical Journal, edited by Dr. Edlin, highly commends the practice inculcated by Mr. Hare, placing it in contrast with that of Dr. Searle as taught in a volume that gentleman has persuaded the Court of Directors to send out to the medical officers of the service. The author's object is to institute a comparison of the old and modern system of treatment in remittent fever, and an enquiry whether by combining the two we may not hope for better success. The old system of Drs. Lind and Hunter was to use bark as a specific to prevent those congestions which prove so fatal in remittent fevers. This practice, founded on long and ample experience in the West Indies and America, was followed with much success in the eighteenth century; success limited chiefly by the difficulties of the exhibition of bark in substance-difficulties now greatly lessened by the modern introduction of quinine. About thirty or forty years ago, however, by some strange whim, calomel got into fashion, brought into vogue by physicians who could write but who had never seen malarious fevers in their intensity or in an epidemic form or even in a tropical climate. It became the practice to allow fevers to get a head, congestions to ensue, and then to treat them with bleeding, calomel and antimony. Dr. James Johnson who visited this country as Surgeon to a ship

and who had no more warrant from experience than a few weeks riding at anchor in the river Húgly could supply, by a smart style of writing and a didactic manner, mainly contributed to effect the revolution which banished Peruvian bark as a specific, and brought in what was called the rational system of antiphlogistic treatment in which calomel played the most distinguished part.

Mr. Hare's plot is to effect a counter-revolution, to restore the old Monarch, Peruvian bark, to his throne, and allow the body corporate the benefit of the acknowledged powers of the "revolutionary leaders," bleeding, purging and diet.

It may be mentioned, that Mr. Hare has been practising for several years at Segowlie, on the borders of the Nepal terai, where malarious fevers prevail, and he confidently states his belief in the specific powers of bark when used in the good old fashioned way in the treatment of those fevers. He has seen Johnson and Annesley, with their calomel, tried and found wanting; on reverting to Lind and Hunter he is surprised to find their views so sound and his own practice so successful when he follows their guidance.

Mr. Hare then goes on to shew how lamentably bark was put aside, and how deplorably for the last thirty years, thousands of poor soldiers in particular, have been helped by salivation for fevers, to rotton teeth, premature old age, and a place on the invalid rolls; not to speak of those who have been otherwise provided for, viz., by the undertaker. He adduces some apt quotations in which the authorities are judged out of their own mouths.

He then taxes Dr. Hutchinson, late Secretary to the Calcutta Medical Board, for recommending quinine only "when the fever has disappeared," and adds, that after searching every where, all he can find in books and magazines since Johnson's time till now, is, bleed and give large Calomel purgatives but be very careful not to give quinine too soon!!

After bringing others to reckoning for their bad practice, Mr. Hare next tells us what in his opinion is the proper course of treatment for malarious fever. It is to make the specific powers of bark available without delay to prevent the fatal congestion. For particulars, however, we must refer to the pamphlet itself.

With regard to Dysentery Mr. Hare gives a considerable number of extracts from the most eminent writers on the subject, from Galen to the present time, shewing how unanimously they urge the necessity of clearing the bowels in all stages of the disease; at the same time that they lament the great difficulty of doing this and the injurious effects of the medicines which they were obliged to employ. His quotations shew how fully they appreciate and hopelessly wish for the means of applying local remedies to the diseased surface of the intestine in Chronic dysentery. The Author having learned Dr. O'Beirne's simple and safe method of accomplishing both these desiderata, and proved its wonderful success by some years of

* Hutchinson on Jails.

experience, wishes to recommend it to his brethren. It consists in passing a long flexible tube above the sigmoid flexure of the colon and then using, most copious enemata. For other details we have no room. If applied it will save, he believes, the lives of hundreds who now die by the scourge of India. Dr. MacGregor, of Simla, truly says of dysentery, writes Mr. Hare, that it " destroys more European and native soldiers than cholera and all other forms of disease together"-and "it is extremely distressing to the medical officer to have daily proof of the utter inutility of his drugs in this disease.'

Mr. Hare has found a similar plan not less useful in chronic dysentery, the long tube enables astringent lotions to be injected far enough to do good. We would suggest to the author to republish some time hence this interesting little book, and to add a selection of cases from European hospitals. There is an earnestness about the style which at least commends the substance to the good sense of every reader of considerate mind. The unfrequency of medical writing in India compared with the vast opportunities enjoyed by the profession induces us to notice the opinions of those who do appear before the public with the more attention. We owe our thanks to Mr. Hare for his present contribution to the literature of his profession. His medical brethren will canvass his arguments and practice. The discussion cannot but be beneficial, as thereby some forgotten truths will surely be brought to every one's recollection. It is only while we keep in memory what we have learned and read that it is of any practical use to others. Physicians should be copious readers of things new and old, and it is worthy of remark, that most of the successful in practice have also been writers and diligent takers of notes. Dire necessity limits the libraries of Medical Officers of the army to scanty dimensions, but if they would try they would find the diligent noting of facts from the pages of the current publications of the day and of cases as they arise, would not a little contribute to the enabling them to maintain their status in a profession which was wont to be called a "learned” one. The practitioner who reads not and writes not, but satisfies himself with ruminations on lectures and readings he was "put through" ten or twelve years ago, though he may escape with the laity by the aid of a pleasant manner and a natural shrewdness, betrays his profession as a learned science. The literature of medicine is the most amusing of studies. Nulla dies sine lineâ, is a motto we suggest to our medical subscribers and readers.-They should remember that honour calls on them to support their own profession, a point of honour we fear sometimes over-looked. Though promotion in the medical service be slow, and talent be indifferently rewarded, the profession itself, be it remembered, has been adopted for better for worse, and it should either be abandonned, or its dignity should be well maintained.

SANDERS, CONES AND CO., TYPS., No. 7, MISSION-ROW.

MISCELLANEOUS NOTICES.

1. The Sailor's Horn-book for the Law of Storms; being a practical exposition of the Theory of the Law of Storms, and its uses to Mariners of all classes in all parts of the world, shewn by transparent Storm-cards and useful lessons. By Henry Piddington, President of Marine Courts of Enquiry, Calcutta. London, 1848.

2. A Fifteenth Memoir with reference to the Law of Storms in India, being the Hurricane of the H. C.'s Steamer Cleopatra, and the Ships Buckinghamshire and others, on the Malabar Coast, 16th and 18th April, 1847. With the Hurricane of the H. C. S. Essex in the Arabian Sea, June, 1811. With Remarks for Steamers in the Eastern Seas. By Henry Piddington, &c. Calcutta, 1848.

HAVING very lately treated, at no inconsiderable length, the highly important class of phenomena whose investigation has resulted in the ascertainment of the "LAW OF STORMS,

we must content ourselves now with a brief notice of those fresh contributions which our indefatigable townsman has just made to the practical literature of the subject. We gladly embrace the opportunity afforded by their appearance while we are yet fresh from a somewhat extensive study of the subject, to supplement our former article by a few observations on one or two points, on which, partly from limitation of space, and partly from an unwillingness to violate the "unities," and unduly distract the attention of our readers, we refrained from touching before. These observations we shall offer incidentally, as the topics to which they relate come before us, in the course of our notice of the books whose titles are prefixed.

Mr. Piddington's object in the "Horn-book" is to give a plain and practical digest of all that has hitherto been ascertained regarding Hurricanes or revolving storms, with constant and direct reference to the bearing of the law on the practice of navigation :

"What I propose in this work is, to explain to the seaman, in such language that every man who can work a day's-work can understand it, the Theory and the Practical Use of the LAW OF STORMS for all parts of the world; for this science has now become so essential a part of nautical knowledge that every seaman who conscientiously desires to fulfil his duties, from the Admiral of a great fleet down to the humble Master of a West India or Mediterranean trader, must wish to know at all events what this new science is: of which he hears it said, that it teaches how to avoid Storms-teaches how best to manage in Storms when they cannot be

* Calcutta Review, No. XV. p. 52.

d

avoided—and teaches how to profit by Storms! A man who thoroughly understands all this, must have as great professional advantages over one who does not, as our fleets and ships of the present day, when scurvy is almost unknown, have, in that respect, over those of the days of ANSON, when whole crews were swept off by it.”

Our author first gives us a very brief history of the science, from the first recorded suspicion that certain winds might be rotatory, down to the full development of the law in the work of Col. Reid; and then he gives a set of definitions necessary to prevent mistakes on the part of his readers. One new term adopted by our author, we think a decided improvement; or rather, we should say, we think that some new term was necessary, and that the one he has coined is as good as any other. The terms breeze, gale, storm, and hurricane are generally used very vaguely, but always with reference merely to the force of the wind, independently altogether of its direction. The only exception that we know to this statement is in the case when the last mentioned term has a certain national epithet prefixed to it; an “Irish Hurricane" meaning, as every one knows, one in which the wind is even up and down!" and down!" The law of Storms having reference chiefly to the direction of the wind, it becomes desirable, and even quite necessary, to have a word that shall denote all revolving winds, without reference to their intensity. The word which our author coins for this end is "CYCLONE," which, as we have said, we think is as good as any other, and indeed rather happily invented. It is to be understood as implying merely that the winds to which it is applied have a tendency to circularity" in their direction, without dogmatizing as to the precise nature of the curve which any given particle of the air may describe. It seems to us an incidental advantage of this term, that it may be adopted into the French as readily as into the English language, and we may be allowed to express a hope that it will be adopted by the meteorologists of that country, to the supercession, in this application, of the term tourbillon, which is not sufficiently definite for the purpose.

"

The next subject that meets us is one of those on which we wish to offer some observations. It relates to "various theories as to the motion of winds in Hurricanes," and to "various theories as to the causes of hurricanes;" in other words, to the questions, how does the wind blow in a hurricane? And why does it blow so?

The former of those questions we answered didactically in our former article on the subject. We recur to it now, only in order to notice the theory of "Mr. T. P. Espy, of Philadelphia, supported by Professor Hare, and some other American philosophers. This theory is that a hurricane is not a revolving storm, or to use the new nomenclature, a cyclone, at all; but that the winds blow in all directions towards a centre, that centre being itself in motion along the track of the storm. These winds meeting at the central point are supposed to neutralize each other, and produce the central calm.

As meeting tides and currents smoothe a firth.