"I was in this state of uncertainty, when chance presented to my notice, a few days ago, a most favourable opportunity of witnessing a case which has had the effect of leaving no doubt on my mind that Entero-mesenteric Fever does actually occur in certain of the solipedous animals.

"A donkey, about six weeks old, died after having been affected with a severe diarrhoea for about eight days. It was brought to my laboratory; and on examining the body, I could find no traces of disease anywhere, save and except those very lesions which we meet with in a human being, that has died during the first stage of typhoid fever. I have now the honour to submit to the inspection of the Academy a faithful representation of the vascular injection observed in the small intestine, cæcum, and commencement of the colon.

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I may here mention that the Peyerian glands in this animal are naturally much developed; but their appearance is very different from what was found in the specimen that is now exhibited. For here not only do they project considerably upon the internal surface of the gut, but several of them present a decidedly red colour, while around others the mucous membrane itself is more or less highly congested. One of the groupes was ulcerated about its centre; but most of them were merely puffy and tumefied. The mucous lining of the small gut was of a reddish colour throughout: this appearance was most conspicuous in the jejunum and upper part of the ileum The entire length of this intestine was filled with a dirty-looking grey or reddish-coloured fluid. There was no appearance, in any part either of the small or large bowels, of the plastic lymph which is generally observed in cases of genuine dysentery. The mesenteric glands were swollen, and several of them were so highly injected with blood as to have a red colour; others had only a rosy hue, with numerous dark striæ on their surface. The anatomical appearances therefore in the ileum and mesenteric glands were clearly such as are observed in the bodies of those, who die in the first stage of typhoid fever. The same thing may be said of those presented by the cæcum; for the lining membrane of this gut also was of a lively red colour, and looked as if it were covered with a considerable eruption of papula, attributable to the increased development of the isolated crypts of this bowel. The pyloric extremity of the stomach exhibited a large patch of ecchymosis; the spleen, liver, kidneys, and bladder were sound; so likewise were the lungs, heart, brain, &c.

"We thus perceive that in this animal, which died of an acute disease chiefly characterised by the existence of diarrhoea, the only morbid appearances witnessed on dissection were an increased development of the Peyerian glands, ulceration of one groupe of them, a general enlargement of the solitary glands of the large intestine, redness of the mucous membrane of all the bowels, tumefaction of the mesenteric glands, and the presence of a sanguineous fluid in several parts of the small intestine-an ensemble of lesions, which, as far as we know, has not its analogue, except in those which characterise typhoid fever in man."

Such is the case adduced to prove the existence of typhus in the lower animals now for the learned reflections of the accomplished narrator.

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I must however admit that the question, as to the existence of this fever in the lower animals, is not completely solved by a single fact; but the present instance may probably suffice to draw the attention of veterinary practitioners to the subject, and lead them to examine, more minutely than they have hitherto done, the state of the intestinal mucous glands in the serous and sanguinolent diarrhoea which is so common in the young of our domestic animals.

"The allusions to the state of these glands in veterinary writings are but few, and very far from satisfactory. In the numerous works, which have at different times been published on the typhoid affections of cattle, we find the authors insisting much on the diffused and ecchymotic redness of the intestines, the swelling and softened condition of the spleen, occasionally the softening of the lungs

also, the alteration of the blood-morbid states which are tolerably common in certain forms of Typhoid fever. But little or no notice is made of any lesions of the intestinal and mesenteric glands-the very lesions to which so much importance is attached in human pathology."-Gazette Medicale.

Remarks. It is certainly not from any importance in the contents of the preceding note that we are induced to append a few observations of our own, but rather from our surprise that so distinguished a physician as M. Rayer should have given expression to such statements as we find in it.

That a man of his experience and research should deem it worth his while to address a formal letter to the leading medical association in his country, in order that he might convey to its learned members the important intelligence that he had found the mucous and mesenteric glands somewhat red and swollen in a young ass which had been affected with diarrhoea, seems to us most passing strange! And then too the extraordinary inference which he draws from this interesting discovery:—what is it?-nothing more nor less than that this one fact affords a strong and very reasonable presumption that Typhoid fever may affect the lower animals as well as man!

Some of our readers may say that they do not perceive the sequitur in this important proposition. If so, we take the liberty of telling them that their blindness proceeds not so much from the darkness or uncertainty of the problem itself, as from the dulness of their own minds. Do they not know that it is an undisputed (at least by the majority of the French physicians) axiom in pathology, that typhoid fever is a certain morbid state of the intestinal and mesenteric glands? and is it not therefore as clear as noon-day that the converse of the axiom must also be true, viz. that this said morbid state of the bowels is typhoid fever? Let them observe for a moment how this simple syllogism explains and illustrates much that is otherwise obscure in pathology. For example, the blood is well known to be fluid after death from lightning; so it is also in many cases of fatal poisoning; as well as in putrid fevers; in pestilential cholera, &c. Here then is a feature common to all these morbid states. Is not the inference then quite transparent, that they are all identical in their nature, or at least that they all belong to the same family? Such we think to be a fair parallel to the case adduced by M. Rayer, and the reasoning which he has founded upon it.

That the mucous membrane and glands of the intestines should exhibit some traces of irritation or even of inflammatory action after a protracted diarrhœa, is, one might suppose, an almost necessary consequence. Is not the conjunctiva usually swollen and reddened after much weeping? and is not the urethra similarly affected when it has been irritated and inflamed? But it is unnecessary to pursue this subject, as it is not likely that any British physician will be biassed by such shallow analogies as our author has employed on the present occasion. What we chiefly regret is to see, that some of the very leading men in France, at the present day, are still so very far from the very threshold of a safe and

Perhaps many of our readers will remember that not a few of the leading men in Paris, including Dupuytren, at the time of the invasion of the Asiatic cholera, came to the important pathological conclusion that the seat and proximate cause of this formidable stranger disease were an hypertrophied and (occasionally also) an ulcerated state of the Peyerian and Brunnerian glands of the intestines ! Their favourite remedy, if we remember aright, was the acetate of lead-which, it was alleged, acted as a direct soothing and antiphlogistic sedative! The patients died, as a matter of course; the post-mortem was always most elaborately performed, and the appearances found on dissection were, we need scarcely add, in strict accordance with the doctrine in question!! So much for medical science in the 19th century.

truly scientific pathology. How can it be otherwise when they allow their minds to be so blinded and misled by preconceived opinions? The last paragraph in M. Rayer's remarks affords a striking example of this. He tells us that Veterinary writers have often observed in the bodies of animals, that have died of typhoid affections, a softened state of several of the viscera and various abnormal conditions of the blood; but that they have not noticed any lesion of the mucous glands of the intestines. The inference, that we should be inclined to draw from such a statement, is that the former phenomena are in fact the pathognomonic anatomical characters of the disease-a statement quite in accordance with what we find in the bodies of those who die of malignant fevers. M. Rayer however seems to take a different view of the case; for, without overlooking these phenomena altogether, he considers them as of very subordinate importance, in an ætiological point of view, to the altered condition of the mucous glands.-(Rev.)

ON THE COINCIDENCE AND ANTAGONISM OF CERTAIN DISEASES.

We have already, in the present Number, made one or two allusions to this subject, which for some time past has been one of the favourite themes of discussion among the Savans of the French Academy. M. Boudin, (who was for some years with the army in Algeria and is now physician of the Military Hospital at Versailles), is one of the most active supporters of the new doctrine of antagonism of diseases,-so far at least as regards the mutual repulsion of marsh fevers on the one hand, and of typhus and pulmonary consumption on the other; and hence, as we are told, wherever the first are very prevalent, the latter are kept in abeyance, and vice versa. This gentleman has written a long letter (apparently in reply to some strictures that had been made on his former observations) on the subject: from it we select the following somewhat grandiloquent extracts. "Whenever a novel truth makes its appearance on the horizon of science, there arises almost immediately against it a host of opponents-men on whose banner cannot always be inscribed as a motto the love of truth.'

"If it be the destiny of every truth to require, like the fruits of the earth, a certain period of time before it can be matured, there are at the same time in man's heart two instinctive feelings which tend to secure the necessary proof or testing, so to speak, of this evolution. The first of these is the AMOUR-PROPRE of certain persons which leads them to deny every thing that is out of the usual course of received opinions; and the other is the inertia of the crowd, who are so apt, at once and without reflection, to accept the bold asseverations which an inexorable routine is ever ready to oppose to the progress of true knowledge. When a man of a certain amount of talent allows his mind to be impregnated with any error, it is rare that he does not succeed in environing it with a host of arguments, which, in the eyes of the multitude, constitute a satisfactory demonstration of its truth.

"It is little more than two months ago since a man, who holds a high place in the hierarchy of science (M. Rayer) suggested to the Academy to institute some enquiries as to the relative frequency of phthisis in marshy countries—a question mooted in my Treatise on Marsh Fevers, and subsequently developed at greater length in my Essay on Medical Geography.

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By adopting with acclamation this important suggestion, the Academy paid a solemn homage to the value of these opinions; but this very act was no sooner known than it became the signal for an outburst of violent opposition-which however has had no other effect but that of more firmly establishing the truth of the proposition in question.

"It was at first the Strasbourg school, that represented itself as refractory to the law of Antagonism. But it was no difficult task for me to demonstrate that the physicians there confounded the diseases of the marshy districts of Alsatia with those of the non-marshy districts; the diseases of the city, properly so called, of Strasbourg with those of its environs, including the citadel and other buildings; and lastly, the diseases that are truly and legitimately called endemic with those that are merely accidental or imported. I likewise pointed out the vague assertions and the utterly unsatisfactory and fallacious reasoning that were used by these gentlemen.

"The next adversary that presented himself was M. Fourcault, who pretended that I had far too much overlooked the agency of the mere moisture or dampness of places, as a potent cause in inducing various diseases. But if he had read with due attention what I have written on the subject, he must have seen that I have enumerated many facts to prove that the circumstance of humidity alone will not at all account for the immunity of certain places from phthisis and typhoid fever. At Brest, for example, which is damp but not marshy, we find that one out of every four of the convicts there die of pulmonary consumption; whereas at Rochefort, which is marshy as well as damp, the mortality from this disease does not exceed one in thirty-six.

"We are rejoiced to find that, with the view of investigating this subject, the Academy of Medicine at Athens has proposed as a subject of discussion at the approaching Concours the question, 'What is the amount of influence which the marshy districts of the country have on the development of tuberculous disease."

"Two centuries ago, intermittent fever was rife in London and its neighbourhood: James I. and Cromwell are reported to have died from it. Now-a-days the disease is scarcely at all known there; while phthisis and typhoid fever have unquestionably become greatly more frequent and destructive.

"Since the drying of an extensive marsh between the lakes of Zurich and Wallenstedt in Switzerland, ague has disappeared from the surrounding country: but, alas! consumption has become much more common in consequence. A similar pathological transformation is reported to have taken place in New York within the present century.

At

"To recur once more to Strasbourg, let us hear what M. Forget (who has very zealously impugned the new doctrine of antagonism) says of his practice, as it is from the data, obtained from this, that he deduces his main argument. my clinique in the hospital, I have had 269 cases of typhoid fever and 230 of phthisis: the latter figure is indeed much below the actual number, as we do not admit any cases of pulmonary consumption into the wards, except when the disease is in its first stage.' Now even in this statement there is a confirmation of our doctrine that the two diseases, here named, are usually indigenous in one and the same place. M. Forget proceeds to say: In the course of these six years and four months, I have had 335 cases of intermittent fever, or very nearly one case during every week.' From this circumstance, the Professor infers that ague is very prevalent in Alsatia. We should have arrived at the very opposite conclusion. That there should be only one patient affected with intermittent fever, a week, in the hospital of a city, which contains 70,000 inhabitants, appears to us a pretty strong argument that the disease is of rare occurrence, and is certainly not endemic there. Besides, as we have already said, no person can judge of the diseases of the environs of Strasbourg, and of the surrounding country, by those of the city itself. We should also remember that the statistics of a single hospital are often apt to mislead us as to the prevailing diseases in any great town.

"In the military hospital at Marseilles, we very often find that the entire number of the cases of typhoid fever are supplied by one regiment of the gar

rison, while another regiment which may have arrived, it may be, from Corsica or Africa, shews itself quite refractory to this disease, and gives birth to those diseases only which have been endemic in the countries, where the troops have been residing. Here, then, we have an instance of a hospital Coincidence, but of a geographical antagonism, of different morbid conditions.

"At Strasbourg, on the other hand, there are never any arrivals from Corsica or Africa; but there is, as in all large towns, a floating population, whose former residence ought always to be well investigated by the philosophic physician, to enable him to treat their diseases with success. He must also not forget to take into his consideration the very important circumstance, that many of the inmates of its hospital are the inhabitants, not of the city itself, but of the surrounding country-whose prevailing diseases may be very different from each other. Here is an instance in point.

"The 60th regiment, which came from the Citadel of Strasbourg two months ago, has been obliged to leave a number of its men affected with ague along the whole line of its march; and we have still numerous cases sent to us at Versailles, while the prevailing disorders there are thoracic affections. Now if this regiment had sent its sick to the hospitals in Paris, we should then have had numerous examples of an alleged coincidence of ague with the usual diseases of the metropolis-in other words, we should have had an example of hospital, but not of Endemic, Coincidence."-Gazette Medicale.

Remarks.-Like every other novelty in medical doctrine, that is brought forward in the present day, this alleged law of Antagonism between marsh fevers on the one hand, and Phthisis and Typhus on the other, will doubtless be pushed to an extravagant length for some time, and then it will be apt to be entirely neglected. In all ages, physicians must have observed that certain systemic diseases are rarely found to prevail simultaneously in any place. Influenza and genuine Typhus are seldom found to exist together; and it has often been noticed that the invasion of one exanthem suspends, or entirely arrests, the activity and prevalence of another. But this remark, it may be said, applies to Epidemic rather than to Endemic diseases. True; but most probably the law, that holds true in the one case, is equally applicable to the other.

That pulmonary consumption is not so prevalent in marshy agueish districts, as in those of a different formation, we are ready to admit to a certain extent; and perhaps for this very simple reason, that such localities are not exposed to those very vicissitudes of temperature which are, it is well known, the usually exciting cause of all chest complaints.

But can we say the same as to any antagonism or repulsion between Ague and Typhus fever?-it seems more than doubtful.

Are not the two diseases frequently blended, as it were, together in such places as New Orleans, Sierra Leone, and the banks of the Ganges? for what is the character of the destructive pestilences of these places but that of a malignant remittent fever-a disease intermediate between genuine continued and intermittent fevers, and partaking of the characters of both?

M. Boudin says that, since the disappearance of Ague in London, the frequency of Typhus and Phthisis have greatly increased in the metropolis; but then have we not good reason for believing, from the writings of Sydenham, that in his day grave continued fevers were quite as common, and indeed more so, than they are now? We suggest these circumstances, not so much with the view of denying the truth of M. Boudin's doctrine, as in the hope of guarding him and others from carrying it to an extravagant and erroneous extent.—(Rev.)