they are of no value, as they merely show the numbers attacked in each year of service, without giving the strength out of which the cases occurred. From such data it is obviously impossible to estimate its relative prevalence among the different classes of troops. The predisposing causes of the disease are alleged to have been fatigue, crowded state of the barracks, those excesses into which young men are apt to run on first joining the army, with excessive drill, nostalgia, and the excitement attending the change from civil to a military life. It is said to have prevailed especially in the months of January, February, March, and April-periods corresponding with the arrival of the conscripts at their regiments. No meteorological phenomena were observed, which could account for the prevalence of the epidemic; nor was there any greater amount of cerebral disease during these years. No grounds exist for supposing that the disease was contagious.

The epidemic meningitis presented itself under two forms: 1st, of excitement, and, 2d, of collapse.

1. That of excitement. In this form there was a strong, quick pulse, sparkling eyes, red face, quickness of speech, headache or neckache, occasionally convulsive movements, and the patient made frequent complaints. Consciousness sometimes remained unimpaired, while at others there was temporary delirium, alternately disappearing and recurring. length terminated in the stage of collapse.

This at

2. The form of collapse was characterized by general collapse, insensibility, coma. This, however, did not come on suddenly. The patients at first complained of fatigue, malaise, prostration, listlessness, and were often accused by their comrades of laziness and shamming. Dull, heavy headache followed; they lay with their eyes half closed; their speech was slow and painful; pulse slow and small; they had confusion of ideas, and vertigo. Coma was generally not complete; but although the patient could be roused, he answered questions with difficulty.

Although this form was usually the consequence of that of excitement, it was often developed as the primary stage of the disease. Both forms ran into a typhoid state, and sometimes became complicated with paraplegia or hemiplegia. Rachialgia was an invariable premonitory symptom. In the course of the disease marked intermissions occasionally were met with. Many cases, which were slight in appearance, terminated unexpectedly in death. Towards the end of the epidemic, the disease usually assumed a milder character than at the commencement.

On examination of the bodies after death, the membranes of the brain and spinal cord were found to present all the usual appearances of acute inflammatory action, from those of simple sanguineous injection and thickening up to serous or purulent infiltration. The existence of a coating of false membrane in layers, flakes, or patches, has everywhere been the characteristic lesion."

The remedies employed have been general and topical bloodletting, ice to the head, sinapisms and vesicatories to the extremities, stimulating liniments, and the actual cautery to the spine. Emetics and purgatives, calomel and opium, and mercurial frictions, and, lastly, quinine.

Large bleedings in the early stage of the disease were the only means

of treatment attended with success. The amount of blood to be drawn was measured by the effect upon the pulse, and not by the quantity. Unless treated thus energetically in the commencement, the patient had a very slight chance of recovery. In many of the cases the blood did not show the buffy coat. After the stage of excitement had passed, blisters to the head were found to be attended with benefit.

Such is a brief recapitulation of the circumstances narrated by M. Cas. Broussais relative to the progress, nature, and treatment of this remarkable epidemic-remarkable for the insidious manner of its attack, its extremely fatal character, unless treated most actively and at once, and its being confined almost exclusively to the military. We have seen one or two cases having a strong resemblance to those related in this memoir, but they occurred sporadically; and we are not aware of an epidemic of this nature having ever been observed in this country.

Perhaps we cannot conclude our present remarks more appropriately than by the following quotations from addresses delivered to the students at the Military Hospital of the Val de Grâce. These prove sufficiently that, although in the official journal of the medical department, the aid of statistical investigation has been greatly overlooked, many of the officers are fully aware of its importance; and we trust, ere long, to have it in our power to notice an increased attention to this branch of science.

"We ought undoubtedly," says M. Sedillot, "to value the truths which antiquity has handed down to us, and not to despise the experience of ages; but it is also necessary to apply to them the system of rigorous analysis which characterizes our era... ..We know that the mortality of the army weighs particularly upon the young conscripts; that it is increased by the change of garrisons; that it is greater in some places, as in Paris, or in localities affected by epidemics, than in others; but medicine has scarcely contributed to these results; they almost all belong to the labours of the administrative department. And if we are asked what are the most common diseases, and in what proportion do they attack soldiers, according to their age, length of service, distribution, their former profession, and a thousand other circumstances, we can only give approximative data, which might very easily be rendered certain, if we collected observations of the diseases. What one man could not do, several, by their co-operation, might easily accomplish. Our profession does not admit of repose; and in the intervals of practice we ought to strive unceasingly to increase our knowledge, and to extend the sphere of our usefulness."

"In military medicine, especially," says M. Begin, "statistics ought, as regards the modes of recruiting, the race of men, their regimen, drill, clothing, dwellings, removal from one climate to another, to lead to precise results, which it would be impossible to procure with the same degree of certainty in any other way. Figures, as has been often remarked, are inflexible, and cannot speak falsely; but we must exert ourselves to collect them, and group them according to their analogies; we must require from them only legitimate conclusions, and must bear in mind that the greater the numbers the more surely will the errors arising from negligence, or individual accidents, be cancelled, and truth predominate in the general result."

ART. V.

1. Histoire de la Médecine depuis son Origine jusqu'au XIXe Siècle. Par le Docteur P. V. RENOUARD. Tom. ii.-Paris, 1846. 8vo.

2. Saggio sopra il Modo e le Regole di osservare e massime in Medicina. Del Dr. L. EMILIANI, Prof. Emer. di Clinica Medica e Medicina Pratica nella Regia Universita di Modena, &c.-Modena, 1844. 8vo, pp. 107. 3. Zur Charakteristik der Medicin der Gegenwart. Von Dr. J. M. LEUPOLDT, offentl. ord. Professor au der Universität zu Erlangen.— Erlangen, 1846. 8vo, pp. 93.

4. The Medical Police of the United Kingdom. From the Westminster Review for March. (A reprint.)-London, 1846.

THE student of M. Renouard's history may make much of it, if he be a dexterous reader, and have a vivid imagination. He may conjure up the dead, mighty in medical art and science; he may pass them before him as in a panorama. The shadowy forms of Egyptian priests will head the array; then will follow the scarcely less shadowy Greek priesthood, and the silent and contemplative disciples of Pythagoras. The Cnidians, and then the Asclepiades, marshalled by Hippocrates, will follow these; Socrates, Plato, and Aristotle mingling in their ranks. Then, once more, a long array of Egyptian sages will appear, the masters of the Alexandrian school, flanked by those of Pergamos, with a multitude of disciples, Pagan and Christian, Asiatic and Latin. Close upon these tread the Arabians, intermingled with Greeks of the declining empire; and misty forms bring up the rear, a motley commingled multitude. On they pass, until again Greek figures are visible, marshalling on the men of the dawning middle ages. Strange is their array! bearded and gowned necromancers, cowled priests, short-frocked bathmen and barbers, hooded women. Motley, too, their banners! The symbols of astrology and Christianity are written on them, with the names of Aristotle, Hippocrates, and Galen, of Plato, Avicenna, and Paul of Egina, of Celsus, Boëtius, and Cælius Aurelianus. But the light dawns more brightly as the panorama moves on, and Galileo, Bacon, Vesalius, and Harvey and Sydenham, and sages, whose names are as familiar to the medical student as his own, appear in the scene. They are intermingled, however, with Rosicrucians and alchemists, pretenders, and fantastic dreamers, amongst whom we recognize John Brown and Mesmer, Hahnemann, and our old friend Dickson; he of "chronothermalism," being both last and least.

The contemplation of such a coup d'oeil, as this history of medical progress affords, cannot but instruct us. Who were the greatest? we ask, who the most worthless? how did the great attain to their fame? why were the unworthy worthless? when did medical art advance, and why? when did it recede? A consideration of questions like these must surely be of use to guide the ambitious or the noble of the profession, and to designate the false and frivolous. Those who fully appreciate the value of medical art to society, and rightly estimate the immense power slumbering in its practisers, may surely learn something from the history of two or three thousand years, and be better able to advance the one, or rouse and organize the other.

The profession and practice of medicine has no history anterior to the early Greek age. From the meagre details handed down by historians, it would appear that a perfect medical organization formed one of the elements of Egyptian society at the time Herodotus wrote; and medical art had its fixed rules, any innovation on which was penal. It would appear, too, that at a period, long anterior to Herodotus, the laws of hygiene formed part of the moral or religious code of Egypt, and probably of the nations of India and Central Asia. What influence these ancient doctrines had upon Greek literature is uncertain, but it must have been considerable, for it cannot be doubted that there was an extensive interchange of thought between the Greek and Egyptian priesthood, and in later times, between the Greek and Asiatic philosophers.

M. Renouard divides medical history into three great ages. The first includes the foundation of medical science, and extends from the mythological age to the time of Galen, or the termination of the second century of the Christian era. The second, which he terms the age of transition, includes the time between the end of the second century and the commencement of the fifteenth. The third is the age of renovation, and includes the time from the commencement of the fifteenth century to our own era. These ages are subdivided into periods or epochs. The first is the primitive period, or period of instinct, and ends at the fall of Troy, about twelve centuries before Christ. The second includes the mystic, or sacred period, and occupies from the fall of Troy to the dispersion of the Pythagoreans, 500 years before Christ. The third is named the philosophical period; it occupies about 180 years, and terminates with the foundation of the schools at Pergamos and Alexandria, 320 years before Christ. This school commenced the anatomical period, which ended with the second century after Christ. It was followed by the Greek period (the fifth), which continued until the destruction of the Alexandrian library, in 640. Science then passed over to the Arabians, and the Arabian period commenced, to end with the fourteenth century. With the revival of letters, medical science revived, and the erudite period began, which, so soon as the recovery of ancient literature was perfected, ended in the last, or reformation period, and which includes the seventeenth and eighteenth centuries. The first half of the nineteenth century belongs to the present period, and is at present left untouched by M. Renouard.

The progress of medical art and science, and of the medical mind, through those ages and periods, is typified in the progress of each individual student. At the outset, medicine was doubtless instinctive, although we are by no means inclined to place this outset at so late a period of the world's history as the fall of Troy. There is sufficient proof, we think, that it had grown to a science in the great Asiatic empires long before this comparatively modern epoch. But M. Renouard's notion applies accurately enough to European science. There is satisfactory evidence that two points only were involved in medical practice in Europe at this early period. The one, was a succinct description of diseases, or nosology; the other, an account of remedies suitable to the cure of the diseases described, or therapeutics.

With the progress of medical observation, it would doubtless soon be found, that a knowledge of healthy structure and function conduced

materially to a better knowledge of nosology and therapeutics, and thus the sciences of anatomy and physiology would arise. The prevention of disease would also be an instinctive consideration, and hygiene would be developed. These, then, nosology, therapeutics, and hygiene, are the kernels of medical science. M. Renouard adds two other branches, orthopædy and phrenology, as completing medicine, which he defines to be the science that has for its object the preservation of health, the cure of disease, the physical perfection of mankind. A more comprehensive, but not a more concise, definition might be adopted than this; but it is sufficient for our present purpose, which is to inquire how this object can be best attained.

The works before us sufficiently indicate the agitation of the professional mind on this point. These examples taken from several such, mark the characteristics of the present epoch of medicine. They prove that the professional mind is bent upon a fuller development of medical science and practice than has been yet recorded in the world's history. Like straws on a deep and mighty current, they show its direction and course. The resolution is evidently taken, that there shall be a fuller investigation of theories and principles; a higher appreciation of the transcendent importance of medicine; a more systematic attempt to concentrate all human knowlege to work out its objects, regardless of prejudices and dogmas. We shall, therefore, take these works as text-books for our purpose, and proceed to draw such lessons of experience from the past, as may enable the profession to work out more successfully a nobler future.

Looking upon the panorama of medical history, we find it divided into two great periods, each in one degree the counterpart of the other. The one extends from the Greek origin of the science to the irruption of the Saracenic tribes, and is complete in itself, inasmuch as it comprises the first rise and extinction of medical science in Europe. Just as the knowlege of Asia and of Egypt was extinguished in passing over with empire to the Greeks, so the knowlege of the latter passed over to the victorious Arabians, and Europe sunk into barbaric darkness. This period continued until the age of renovation, which began with the fall of Constantinople, the immigration of learned Greeks into Italy, and the culminating point of Saracenic power in the fourteenth century. This second period is, however, as yet incomplete, inasmuch as the extreme point of development is not yet reached. In all other respects, it may be compared with the first. It had this advantage, however, that it commenced on a wider basis than its analogue. The accumulated knowlege from which the science of the first period was developed was imperfect, because the sciential records of the mystic age antecedent to it, were confined to an exclusive priesthood and a hieroglyphical language, and much, therefore, of Asiatic and Egyptian learning was lost to the Greeks. They began science almost anew, and transmitted their accumulated knowledge to their successors in a living language, and a language most perfect and rich. It was also expounded to them by men of acute and polished minds, who read and spoke the language in which it was written. This was an immense advantage; it was the advantage which the student with a master possesses over the student without a master. Nevertheless, the powers which guided the development of medical science in the two periods, the obstacles which