mixed through it, sometimes as a purulent mucus mixed with water, sometimes red-coloured with blood, and sometimes colourless, can be discovered with certainty only by means of the microscope; sometimes we find portions of coagulated exuded lymph, in which by proper manage. ment with the microscope we can recognize the fibrous structure of the coagulated fibrinous matter. The typhous stools thus readily dividing themselves into two strata exhibit to view by means of the microscope an extraordinary quantity of prismatic crystals of the triple-magnesian phos. phate, besides mucous-corpuscles, and fragments of the epithelium of the intestinal mucous membrane connected together. In like manner, in intestinal typhus, the fluid stools divide themselves into two strata, of which the inferior, purulent-looking, is recognized under the microscope as constituted of mucus and pus-corpuscles; the superior stratum, in which these same corpuscles are still suspended, and sometimes fatty globules may also be discovered, is generally distinguished by a considerable quan. tity of dissolved albumen. The watery stools in cholera present under the microscope, among other objects, numerous crystals of triple magnesian phosphate; the purple red colour which these stools assume, when they are mixed with nitric acid, seems characteristic.

We may now notice the peculiar qualities of the vomiting which occurs in violent inflammations of the abdominal organs, and in carcinoma of the stomach; in the former case a watery, slightly mucous, green-coloured fluid, often extremely abounding in fat, is vomited forth; the fatty contents of which may be distinguished even with the naked eye, but still better with the microscope; in the second place, the mucous chocolatecoloured discharges contain a dark-coloured amorphous matter, several large yellow-coloured cells, which are filled with a granular mass, which also contains small fatty globules mixed with them. Besides a more or less considerable quantity of fatty drops seems to be peculiar to this vomiting.

REPORT OF THE COMMISSIONERS FOR INQUIRING INTO NAVAL AND MILITARY PROMOTION AND RETIREMent. With Appendices. Medical Department of the Army. Presented to both Houses of Parliament by Command of Her Majesty. 1840.

In a recent number we glanced at the rise, progress, and decay of the Army Medical Board in England; and we took occasion to mention, at the same time, some of the acts of the Medical Boards in the East Indies, which, in our estimation, entitled them to a similar fate with their prototype of the mother country.

We believe it will be found with Boards, as with individuals—that they can only be seriously injured in character by their own acts of omission, or of commission; and we anticipate that we shall be admitted, by impartial persons, to have exhibited enough of the one kind, and of the other, justly to entitle both the European and the Asiatic Boards to the doom which Decessarily awaited the one, and which as necessarily impends over the

others.

The present admirable Director-General of the British Army Medical Department joined what was still called "the Medical Board," in 1815; and, though much the junior officer, continued the influential, and, as may well be supposed, the guiding and ruling member till 1833, when, by the natural removal of the last rags of the old system, he became the sole and responsible head of the Medical Department of the Army-a position to which his character and talents, as well as his long and tried services in the East and West Indies, in Egypt, in Walcheren, and in the Peninsula, during the campaigns of Wellington, so justly entitle him-a position in which, we will venture to say, he has not disappointed the expectations of any good man in the army, whether above or below him in station. This is great praise, we know ; and we can assure the distinguished officer under consideration, as well as the public at large, that we make it as advisedly as impartially. We have no motive in stating other than what we believe, and indeed know, to be the truth.

In our former article we adduced sufficient evidence of the crying public evils attending the government of a Medical Board in London; and having done so, we shall not detain our readers with a detail of the feeble, petty bickerings-the vapid, wordy " minutes in dissent"-with which, in their last moments, and when they had lost the power of doing evil, the senior members worried and vexed the kindly-minded and excellent Chief, the Duke of York. Suffice it to say that, though they could never agree amongst themselves on any point, they nevertheless, like other old men, in other parts of the world, objected to everything, however excellent, that came from a junior, or that they could not be made to understand, or of which they could not be expected to see the end;-and thus expired, as full of age as wanting in public honour, the Army Medical Board of England.

No. 93.-5

and their notions we shall notice only, by laughing at them. We leave them to die, along with the "Boards," of their own absurdity; while we again laugh at their groans over the improved and improving knowledge and spirit of the times.

13. We find again that, while a medical board in Bengal was wrangling about red coats bound in black velvet-about white pantaloons, cockedhats and black feathers-a senior member of a quondam Madras board was occupied in much the same dignified manner. "Would it be credited," says Mr. Annesley," and yet it is very true that, the first member of the medical board actually made a remonstrance that the profession felt degraded, because the superintending surgeons were not allowed to wear a gold button-hole." Mr. Annesley declares that, in his time, rank was estimated by the members of the board, not by the professional dignity it conferred, or the position in the army it commanded, but by the high and important considerations of the position of the official circles in Madras it would secure to their wives, and the supreme honour of seeing these ladies handed to dinner "by a member of council, or senior merchant !"

It is needless for us again to refer to the character and merits of Mr. Annesley; and we very much regret that an undue delicacy towards a system he knew to be bad, and towards persons whom he considered to be useless, should, during so many years past, have deterred that distinguished officer from dealing with, and exposing this vile system, and these official abuses, in the searching, unsparing, public manner, that could alone put them down, and put an end to them. He has done it now, however, and done it well.

14. The "Boards," whether in the East or the West, in the North or the South, are exact types of each other, and of that miserable system of organised neglect which, for sixty years, has marred the moral development and professional advancement of the Indian medical establishments, so far as "Boards" could mar a most able body of officers-a system that has never gone beyond the cut of the coat, or deeper than the skin of the wearer a system that has never imagined a commencement at the heart, and a natural progress outwards-a system so miserable as to occasion the wonder no less than the contempt of every man capable of reflection—a system, however, which is now rapidly drawing to an end-deploratus de medicis ac destitutus.

15. Of the three grand requisites to efficient medical administration-a rapid promotion-a selection of staff officers-an experienced, able, vigorous and personal superintendence and control-we have absolutely none in India. This we have proved in every page-almost in every sentence, we have written on the subject.

Lastly. We would do the Governments of India, both at home and abroad, the justice to declare emphatically that, for the shameful neglect of the medical departments of the Indian army, they are not altogether responsible. A Government more considerate, just, and liberal, exists not, or one more disposed to place its servants on a footing of public and private respectability;-but, in the instance before us, the condition of the medical service, its neglected state, its wants, its disabilities, in all their relations, were never, until now, so far as we know, brought fully and fairly to the notice of authority. The services never united-the "Boards never moved--not hing was ever said or complained of in the right quarter,

describing their respective situations, the Commission recommended to give to those staff assistant surgeons, whom it is proposed to place on a level with the regimental surgeon, the appellation of staff surgeon of the second class.

"The regular course of promotion in the army medical service would then be as follows:

1. Assistant Surgeon (staff or regimental,)

2. Surgeon (regimental or staff of the second class,)

3. Staff Surgeon,

4. Deputy Inspector,

5. Inspector.

"The difference of pay between the regimental and the staff surgeon is also insufficient to counterbalance the advantage which the former derives from his mess and other regimental privileges, insomuch that it is practically found that regimental surgeons are frequently unwilling to accept the appointment of staff surgeon. It appears to us also that the nature of the duties which should properly belong to medical officers on the staff does not require that there should be so great a number of different ranks of these officers as at present exists."

For these reasons the Commissioners recommend the substitution of the scale of grades last given, in place of that first quoted, and the abolition consequently of the rank of assistant inspector, while the pay and com. parative rank in the army now enjoyed by this class of officers should be conferred upon the staff surgeon; which appointment should be in future considered the intermediate grade between the regimental surgeon and the deputy inspector of hospitals. These suggestions of the Commissioners have, we believe, been adopted.

The conclusions submitted to Her Majesty's consideration are as follows:

"1. That it is not expedient to alter the existing rules with respect to the promotion of the medical officers of the army, for the purpose of facilitating promotion upon half-pay or by brevet.

"2. That to extend the means of promotion upon full-pay, it is expedient to make the following changes:

1st. To abolish the rank of assistant inspector.

2d. To give to staff-surgeons the pay and half-pay, and the comparative rank with other officers of the army, now enjoyed by assistant inspectors; making also the rank of staff surgeon the regular intermediate step from that of regimental surgeon to that of deputy inspector.

3d. To divide the assistant staff surgeons into two classes, allowing the first class the rank and pay of regimental surgeons.

"3. That it is expedient to allow medical officers retiring after twenty-five years' service, the advantage of reduced instead of retired scale of pay.

"4. That it be recommended to the military authorities of the army to consider of the means of giving to the medical staff officers attached to an army in the field, the services of a soldier servant, which shall avoid to weaken the ranks of the battalions or regiments of the army in the field.

"5. That when not employed in the field, such medical staff officers should receive, as compensation for the services of a soldier, an allowance not exceeding 1s. a day."

We now propose to analyze the evidence of Sir James M'Grigor, and of Mr. Guthrie, as given in the verbal and documentary forms to the Commissioners for inquiry into Naval and Military Promotion and Retirement.

To the question-Do you experience any difficulty in finding surgeons to serve in the army either by summoning those from half-pay, or by new appointments? the Director General answered :-"I have no difficulty in finding well-qualified gentlemen, but I have prepared a statement of the difficulties which I find in carrying on the service." The difficulties set forth are the slowness of promotion, and 1st. That a gentleman, who, after completing an expensive medical education is about to decide whether he will enter the medical department of the army, or pursue his profession in civil life as a physician or surgeon, on looking into the regulations, will observe that after a service of five years he may obtain a step of promotion to regimental surgeon, that in two years more he may be a staff surgeon, in three more an assistant inspector of hospitals, in two more a deputy inspector, and in three more he may obtain the rank of inspector general of hospitals, so that at 39 years of age (24 being the average at which medical officers enter the service) he may attain the highest rank in the medical department of the army." How desirable soever that, for the good of the state and of the service, these rules should be acted up to, the Director General has no difficulty in showing, statistically, how differently this inviting prospect turns out, to the disappointment and chagrin of individuals, no less than to the injury of the service, which, in consequence of the slowness of promotion amongst the assistants, “is languidly carried on."

2dly. That, though old officers may be fit for the discharge of light duty at home, and in some more of the healthy stations, yet, in such service as that of North America at present, or tropical climates, and almost all foreign stations, they are inadequate to the duties; many of them are valuable officers with much service, discharging the duties entrusted to them to the best of their ability, but they cannot be considered as effective officers.

3d. That this stagnation in advancement operates most injuriously in the cases of officers to be selected for the duties of superintendence on foreign stations, where active and able officers are required.

4th. That even the district surgeons at home, not to speak of the other staff officers on the full and half-pay, are old, with constitutions much impaired by previous long service in various climates, and are by no means fit again to embark for foreign service; and this, though they are admitted to be men of intelligence, judgment and discretion.

5th. That from a list of staff officers of the ages of 61, 64, and 65, exhibiting the actual ages of 147 staff officers on the half-pay, the Director General could not, if called on by the General Commanding in Chief, select one from the list equal to the duties of active superintendence on a foreign station. The same authority adds:-I need not to this Board dilate at any length on the important duties which devolve on superintending officers on foreign stations, and the special qualifications required of an officer for those duties; it is sufficient to say that they ought to be active as well as able officers, with experience of service.

6th. That as to the regimental surgeons in a period of peace, particu larly on foreign stations, as in India and the West Indies, the only severe duty falls on the medical officer. In tropical and unhealthy climates, the duties of the medical officers are at all times heavy and unremitting, more particularly so from the repeated reduction in their number on every station;