strength of constitution, but not in reference to disease. In plethora, or the fullest state of activity of the nutritive functions, he found the proportion raised from 0.127 to 0.140. In the lymphatic temperament, where there is debility, the proportion is lower than the average. The proportion of fibrine seems to undergo neither increase or diminution, unless actual disease is present. The aqueous portion of the blood is found in larger proportion in debilitated constitutions, and in less in those which manifest power.

The blood cannot be identical in its composition in all parts of the economy of even the same individual, for its condition on entering and leaving a secretory organ must be very different. Chemistry enables us to fully appreciate the change it undergoes in traversing the pulmonary vessels; and the same thing occurs, in different degrees, in its passage through the structure of other organs. The changes which are effected by means of the various secretory organs, not always occurring alike in different individuals, may give rise to modifications in their temperaments. In reference to the bilious temperament (e. g.) the author observes

"There are cases in which a primitive modification of the secretory powers of the liver may give rise to the biliary temperament of authors. This happens, when from any cause this organ does not extract from the blood the materials of the bile, in sufficient quantity for the necessities of the system. It will be seen that there must then predominate in this fluid too large a proportion of carbonized, and hydrogenous elements, and of fatty, coloring, &c. matters, which should have been separated by the biliary secretion. But other causes may produce the same effects, for these matters are not only eliminated by the liver in the form of bile, but are so, also, by the lungs in the form of water and carbonic acid, by the kidneys, the skin, and various other modes of elimination. Now, if any accident occurs to impede this elimination, hydrogen and carbon will be found to superabound in the blood. This superabundance, and the consequent predominance of venous over the arterial blood, the slower venous abdominal circulation, and the congested condition of all parts of the system where it prevails, form the essential characters of what has been called the bilious temperament." 160.

If the condition of the blood offers the truest material expression of the temperaments, that of the nervous system must not be neglected; for, if the one is the centre of the vegetative life, so is the other the centre of the animal life; and the two have a reciprocal influence on each other. But, as before observed, what has been called the nervous temperament may unite itself with very different conditions of the economy. fluence of the nervous action he offers the following illustration.

Of the in

"Take two men, possessing in the highest degree the sanguine temperament, as described by authors, and predisposed to cerebral congestion. One of these will not be able to bear an elevated temperature. During the heat of Summer, or in a heated apartment, he will suffer much from the afflux of blood to the head; and will become relieved upon a diminution of temperature. The other will prove effects directly the reverse under the same circumstances. Why this difference, each having the same temperament? Because, in the first case, the circulation is slow, and the peripheral exhalation scanty; while in the other, the circulation is active, and when the temperature is high, the cutaneous and pulmonary transpiration is abundant, and the central organs are quickly relieved. But in a cold atmosphere the blood is repelled to the interior, and visceral congestions soon follow. Do you prescribe for these two men, the same regimen,

merely because they are said to possess the same temperament? If so, one of the two must suffer. Is it not evident we must here take into account something besides the external characters of the temperament, or the constitution of the blood, and that the so opposite circumstances observed in the two depend obviously upon the nervous action, which is entirely different in the two cases." 164.

The author declines offering any arrangement or nomenclature of temperaments, satisfied with having pointed out the erroneous ideas prevailing upon the subject, and the mode in which future investigations should be conducted.

Of the distinction to be drawn between temperament and constitution, he thus speaks.

"Temperament is essentially variable: age alone may suffice to substitute one temperament for another; so, also, may hygienic agents, climate, professions, manners, habits, &c. &c. It is not so with the constitution. Every man is primarily endued with a particular constitution, distinct from temperament, and in the study of which the doctrine of hereditariness essentially enters. The constitution may be modified by regimen, but not destroyed. In a word, the constitution is the foundation of the individual being, the temperament is its more or less durable form of existence."

168.

V. THE SUPPLY OF FOOD IN RELATION TO DISEASE AND MORTALITY. By F. Mélier.

The Anti-Corn-Law-League might print this paper among their Useful Knowledge Tracts. The author enters into a long examination of the prices of corn, the prevalence of disease, and the amount of mortality in the eighteenth and nineteenth centuries; and finds that high prices and a high ratio of disease and mortality have ever gone hand in hand. From 1815 to 1835, the population and produce of the harvest each increased just 12 per cent. The influence of the price of corn, however, has become less visible of late years, owing to the increased cultivation of the potato and garden produce contributing to supply the deficiences of bad

years.

VI. ON THE VALUE OF THE MICROSCOPIC EXAMINATION OF THE MILK IN THE CHOICE OF A NURSE. By Alph. Devergie.

M. Devergie, having the superintendence of the public establishment for nurses, took the opportunity of testing M. Donne's researches respecting the microscopic examination of the milk. The following are his conclusions:

Under the microscope, a nurse's milk presents globules of three different sizes, that which contains the largest being the most nutritious. Middle-sized globules are most generally observed. The milk with large globules (which, however, the stomachs of some infants will not bear) is usually, but not exclusively, found in the sanguine-lymphatic temperament. The number of globules (or richness of the milk) is not always

proportioned to their size. Large globules are sometimes found in nurses whose external appearance is unfavourable. There may be considerable difference in the milk in the two breasts, often arising from the habit of suckling especially from one breast. When the difference is very great the nurse suckles exclusively from one breast.

The recommencement of suckling after a temporary suspension is attended with an increased richness of the milk. The age of the milk, the age of the nurse, or the colour of her hair, are not attended with corresponding microscopic appearances. Breasts of a middling size furnish the best milk.

He thus concludes his paper.

"A good nurse should be a woman from 25 to 30 years of age, strong in constitution, having a broad chest, sanguine-lymphatic temperament, brown hair, white and undecayed teeth, complexion, and lips coloured. Her breasts should be pyriform, with clearly-defined nipples, and without the veins being much dilated, or the areola too large. The milk, when placed in a spoon, should be white with a bluish tinge, not too thick, and of a sweet taste. Examined by the microscope, the size and number of the globules will be seen. But when satisfactory in this respect, it may not agree with the child if its assimilative powers are not equal to milk of the character observed. If its health suffer in the experiment, the microscope may be very useful in ascertaining the differences presented by the milk of a new nurse. But there are alterations in the condition of the milk of which we know nothing, and whose nature the microscope does not elucidate." 222.

VII. ON EPIDEMIC CEREBRO-MENINGITIS AND CEREBRO-SPINAL MENINGITIS. By M. Rollet.

These affections have raged, at different intervals, for several years, among the chief garrisons of France-civilians in the same towns, though not altogether exempt, being rarely attacked. Most authors have considered the two affections as being but different degrees of the same disease, but M. Rollet thinks differently, and arranges the cases he has seen in two categories. 1. Those (cerebro-spinal meningitis,) with or without affection of the intellectual faculties, but without any lesion of sensibility or motion; and, 2, (cerebro-meningitis,) those manifesting affections of the intellect, the sensibility and motion, with more or less complete abolition of the functions of the external senses.

He relates 28 cases. All his patients were of the sanguine temperament, and consisted, for the most part, of new soldiers, hitherto unaccustomed to the labours of the camp. The affection occurs especially in Spring and Summer.

We need not enter into a description of the symptoms; and the postmortem appearances chiefly consisted in the altered condition of the pia mater-effusion into the arachnoid, or cerebral ramollissement also sometimes occurring.

Antiphlogistic treatment, of a vigorous character, usually proved useful when promptly applied. When, however, the state of irritation had persisted some time, a condition resembling compression of the brain, attended with complete depression of powers and a filiform pulse, frequently suc

ceeded. The object now is to relieve the oppressed brain by exciting reaction upon the surface of the body, and thus direct the blood from the centre to the periphery of the system. But ordinary means of counterirritation produce no effects upon the skin. The author institutes the following sufficiently vigorous procedures simultaneously. The patient having been laid on the belly, from six to eight slight applications of the actual cautery are made along each side of the spinal column; large sinapisms are applied to the feet, and kept constantly hot with boiling water, while an ammoniacal pommade is rubbed into the inner parts of the thighs and legs, and cupping-glasses are applied to the back of the neck. The re-action usually commences in about an hour, and when it is sufficiently established, bleeding must be practised in proportion to the strength of the patient, applying at the same time cold to the head, and heat to the feet.

Certainly nothing but the desperate condition into which the author represents these patients to have been reduced could justify this treatment, which, he says, he has found very successful.

VIII. ACCOUNT OF THE EPIDEMIC MILIARY SWEAT, WHICH PREVAILED IN THE DEPARTMENT OF DORDOGNE IN 1841. By H. Parrot.

Various provinces of France, especially Picardy, have at different periods been affected, on a small scale, with these sweating sicknesses, which some centuries back committed such ravages in our own country. They have usually been attributed to the miserable physical condition of the people in the districts in which they prevail, as shewn in the bad habitations, want of means of removal of filth, damp, &c. and the use of bad black bread, chesnuts, &c. &c. with an almost utter deprivation of animal food and wine-the French Peasant's beer. Dr. Parrot states that all these circumstances prevailed in the district whose devastation he reports upon; but he seems to doubt how far these causes may have been operative in the production of the disease, inasmuch as its progress frequently took place in a contrary direction to that in which filth and want chiefly prevailed, while the lowest dregs of the population were among those who chiefly escaped. He attributes considerable influence to meteorological causes, and geological peculiarities.

The epidemic continued for five months, manifesting itself in different districts in five separate invasions. It frequently caused death in a very rapid manner, and that so insidiously, that many cases which seemed to be so slight as hardly to call for notice, were among the most fatal, so that, at last, it was laid down as an axiom, that a cure could never be promised. In many patients profuse sweating, followed sooner or later by vesicular eruption, seemed the sole effects of the disease. The health and strength, and especially the appetite, continuing good. In other cases the sweating was profuse beyond conception, accompanied by a peculiar odour, and followed by the development of severe cerebral symptoms: tongue was usually moist but yellow, and the appetite, even in bad cases, urgent beyond constraint. Pulse in bad cases hard, vibratory, and frequent. Epigastric pulsation a frequent symptom. Blood drawn presented softened

coagulum and no buffiness. Post-mortem examination revealed no important lesions sufficiently explanatory of the mortality. Out of 597 cases observed by the author, 321 were women, and a remarkable feature of the disease was its inducing menstruation in women, even prior to their proper periods, and not suppressing it when present. The extraordinary number of menstruating women affected, and the great number of abortions which occurred, justly entitled the affection to be considered a powerful emmenagogue. Persons of robust constitution seemed most liable to attack, and when seized with the disease fared worse than their feebler neighbours. The Sulphate of Quinine (the fever accompanying the disease generally assumed a remitting form) was found to be a powerful means of cure. Accessory means, such as nitrate of potass, venesection, forbidding the excess of covering assumed by the patients, and a due regard to frequent changes of linen, were had recourse to.

The population of the affected district amounted to 83,342: the number of persons affected to 10,805; and the deaths to 797.

IX. ON FORMATIVE HYGIENE (ORGANOPLASTIE HYGIENIQUE). By M. Royer-Collard.

The object of Hygiene should not be merely the preservation of health by the prevention of disease; but, also, by the amelioration and perfecting the instruments of life, enable the organism without danger to develop the entire amount of power of which it is possessed. This second object has been much overlooked, and we are at a loss to point to the rules or principles for its accomplishment. That this is the case has always surprised the author; and he asks the following question

"Since hygiene can always, by the aid of regimen, moderate or excite the vital action, increase or diminish the strength, and direct to a certain degree all organic operations, to what point, also, might not a well considered and systematically combined system of regimen effect a modification in our organs by means of nutrition, and form them as it were as we wish, to develop such a part, to diminish or obliterate another, to change, in fact, artificially, if not the essential constitution of the body, at least its most variable forms which we have been accustomed to term its temperaments?

"Nor is there anything so unreasonable in this à priori. Regimen, in fact, comprehends five principal things,-diet-conditions of the atmosphere-exercise -the generative functions and moral influences. That each of these exerts a powerful influence is known to every one; so that we can very well see the possibility of obtaining results which have been foreseen or calculated beforehand, by means of a regimen in which we can rigorously specify the choice of the material of nutrition, and the direction of the vital powers.

*

Anatomy and physiology have made no remarkable progress for these twenty years, but by the comparative study of man and other organised species. Pathology has scarcely entered upon this path. Hygiene is yet more backward in this respect than any other branch of medicine, and, nevertheless, more than any other, she might find in such a study precious and multiplied facts. The practice of agriculture, the rearing of cattle, and the training of domestic animals, have amassed during ages a treasure of positive observations and experiments ready made. The smallest farmer of our fields possesses ideas in which we are deficient