of a bottle of raw spirits every day! You and I know them too well to doubt that the other three-fourths go down after the first." It has long been, and still is, a deep reproach to our country that this most mischievous practice is not only sanctioned but is actually instigated and encouraged by the Government for the maintenance of the " canteen fund," which pays the expenses of the theatre, fives-court, and other amusements for the men, and even for the covers of the caps which they wear. In the West Indies this state of things was (is?) still more disgraceful; for there the Ordnance authorities derived, a few years ago—and perhaps still derive-a considerable revenue each year from letting, at exorbitant rents, canteens; the proprietors of which, nevertheless, made large profits by the sale chiefly of the worst spirits at the highest price to the soldiers. The subject is pointedly mentioned in the description of the barracks in Jamaica, in the official report on that island in 1853. The Commissioners most justly reprobate the existing system, and urge its immediate discontinuance. As to the best drink for the soldier, no one will doubt that the use of sound malt liquor is greatly to be preferred to ardent spirits; but the constant or unrestricted use of malt liquors is not without its disadvantages in tropical climates. We agree with Dr. Bird that light wines, or the stronger ones diluted with water, effervescing and such-like beverages, with tea, coffee, and cocoa, are the safest and best drinks. No allusion is made in the Report to the use of tobacco. Smoking in moderation is, we think, rather useful than otherwise in these climates, provided always it be not associated with tippling. Few things are more refreshing after fatigue in sultry weather than a pipe or cigar with a glass of iced water: it invigorates without excitement.

The subject of diet of the soldier is discussed at considerable length by the Commissioners; but our limits prevent us following them on this matter or on that of dress, offering but the single remark in reference to the latter, that experience is strongly in favour of woollen clothing next to the skin, and of the outer dress being loose and easy. Then, too, the recreations and amusements of the men; the great and seemingly increasing amount of venereal disease in most of the stations; the restrictions upon marriage among the soldiers; the bad accommodation hitherto provided for the married men and their families; the too-frequent neglect of the poor women and children, with the frightful consequences contingent upon this neglect, as at Dum-Dum in 1858, the sanitary condition of the native lines, bazaars, and cities where so much of the disease among the European troops is bred-all merit attention if we had space. The evidence of Sir John Lawrence on the marriage of soldiers should be read by every one interested in the welfare of the army. Besides these questions, the great subject of hill stations and of sanitaria, whether on high elevations or on the sea-coast, or away from India, as at the Cape, Australia, or Tasmania (which, although not mentioned in the Report, is worthy of notice), would require an article to itself to do it justice. The general scope of the evidence, both in India and in other tropic lands, seems to be that

heights of about 2000 feet above the surrounding plains offer, on the whole, the most suitable positions for barracks in the hills. We have been surprised to find that the camping out of troops once or twice a year has been so rarely resorted to as a hygienic and sanitary precaution in stations on the plains; it has long seemed to us that it would be highly useful for the health of the troops and the wholesomeness of the barracks. The limitation of the period of service in India to ten years, and the location of at least a third of the whole force on hill stations in rotation, are excellent suggestions. It requires but the efficient carrying out of these and the other recommendations of the Report to bring about, and that speedily, an immense diminution in the sickness in our Indian army, and a reduction in the mortality by at least one-half-say from 50 to 25 or even to 20 per 1000 of the strength in the year. And while so much is being done for the one service, let not the other, equally entitled to the nation's solicitude, be overlooked. The losses by disease in the Navy on the East India station of late years have been excessive, considerably greater than they used to be, and even beyond the losses in the army. The subject clearly demands inquiry, so that the cause or causes of this unsatisfactory condition of our ships of war may be discovered, and the proper remedy applied. Moreover, our military and other establishments in the West Indies and other distant possessions stand much in need of a like searching inquiry as that directed to our empire in the East. It is only a few years ago that an entire fourth (between three and four hundred men) of a garrison there were swept off by malignant fever within two or three months. Wherever we turn, abounding evidence will be found that an enormous proportion of the sickness, wretchedness, and death in communities and peoples is due to causes patent as noonday, and easily capable of mitigation or removal. The field is a glorious one to the medical philosopher and the philanthropist; and the appearance of the great Indian Report will, we trust, serve to stimulate inquiry and exertion everywhere; for wherever the field is intelligently and earnestly cultivated, a rich reward of the truest beneficence will infallibly be reaped.

Little did we think, while writing these pages, that the distinguished man whose opinions we have several times quoted should now be on his way out to undertake the Government of India. May his life be long spared to carry out, among other social reforms, the measures necessary for improving the health, and promoting the moral and religious welfare of the soldier!

PART SECOND.

Bibliographical Record.

ART. I.-1. The Causes and Nature of the Vascular kind of Bronchocele, and of the Pulsations and Palpitations termed Anamic. By THOMAS LAYCOCK, M.D., &c. (Reprinted from the Edinburgh Medical Journal' for July, 1863.)

2. Vascular Bronchocele and Exophthalmos. By J. WARBURTON BEGBIE, M.D., &c., Edin. (Reprinted from the Edinburgh Medical Journal' for September, 1863.

THE two papers before us refer specially to the causation of the interesting disease which forms their subject. The first, to attempt to establish a relation betwixt, and to ascribe to a common cause, its three characteristic symptoms-viz., vascular and cardiac excitement, enlargement of the thyroïd gland, and protrusion of the eyeballs—was Dr. Begbie, senior. In 1849 that physician read to the Medico-Chirurgical Society of Edinburgh a paper, in which he attempted to prove that this remarkable triad of symptoms originated in an impoverished state of blood. This paper forms one of those elegantly-written and practicallyvaluable essays in the author's 'Contributions to Practical Medicine.'

Since Dr. Begbie, senior, made known his theory of the anæmic origin of exophthalmic bronchocele, another view has been advanced, ascribing the disease not to a humoral origin, but to a special affection of the nervous system, termed a neurosis. (Stokes, Trousseau, Aran.)

In the first of the papers placed at the head of this notice, Dr. Laycock seeks to apply the results of modern physiological research in explanation of the various symptoms of this form of bronchocele. He believes that all the phenomena are due to a "neurosis" of the cerebro-spinal tract, or rather of several vasomotor centres in the spinal cord. For example, the exophthalmos is explained by supposing an affection of the " oculo-spinal" centre, which Budge and Waller showed to extend from the first cervical to the sixth dorsal nerve, and which, as Bernard has recently shown, sends its nerves to the eye through the first and second dorsal nerves. The bronchocele again, which is essentially a dilatation of the vessels of the thyroïd gland, Dr. Laycock believes due to a lesion, of a paralysing kind, of the trunk of the sympathetic. The cardiac palpitations are attributed to a lesion (of an irritative description ?) of the newly-discovered centre for cardiac excitation-of a tract of the spinal cord extending from the seventh cervical to the fifth dorsal nerve (Von Bezold). As a further

explanation of the cardiac and vascular excitement, an increase in the heat of the blood (from paralysis of the capillaries in certain parts) is shown to have a stimulating effect on the muscular tissue of the heart and arteries. Finally, the therapeutic action of cold is explained on the supposition that it diminishes the cutaneous production of heat.

As showing the nervous mechanism of various symptoms, Dr. Laycock's paper is very interesting. But in furnishing us with the causation of this curious group of symptoms we think it fails. What is a "neurosis?" Is it an irritative or a paralysing lesion, or a mixture of the two? Dr. Laycock's theory would imply the latter. The causation of one symptom demands an irritation, of another a paralysis, of the vaso-motor nerves. Thus, exophthalmos is artificially produced, not by division of the cervical sympathetic or of the two first dorsal nerves, but by galvanic irritation of these nerves or their spinal centre (Bernard). Again, the bronchocele which originates in a dilatation of the vessels of the thyroïd would point to paralysis (or in an experiment, section) of the cervical sympathetic. Adopting Bezold's experiments, an irritation of the cardiac centre produces increased cardiac action (palpitation). The exophthalmos implies irritation of the sympathetic trunk: the enlarged thyroïd implies an opposite condition of the same nerve: a neurosis would thus seem to be a strangely-compound lesion. Dr. Laycock would have done well to have pointed out this difficulty in his theory, and to have given some explanation of what appears to be a flaw in his physiological argument.

There are other points of interest on which we would remark, but space forbids, and we hasten to notice Dr. W. Begbie's paper, which may be regarded as an able defence of the anæmic origin of this disorder. Whilst Dr. Laycock considers exophthalmic bronchocele as a disease of innervation, Dr. Begbie advances arguments tending to prove it to be a disease of nutrition; or rather, while admitting the nervous mechanism of the disorder, he attributes its cause to an impoverished state of blood. He points out the frequency with which the sufferers from bronchocele have presented adequate cause of blood impoverishment (uterine hæmorrhage, hæmorrhoïdal flux, leucorrhoea, diarrhoea, &c.), and also the frequency of the signs and symptoms of anæmia itself; that the remedial means are those of anæmia, and that the structural changes in the heart (noted by Sir H. Marsh and others) are such as long-continued functional disease in connexion with anæmia would produce. The order of sequence in the symptoms are stated to be-1, blood impoverishment; 2, cardiac and vascular disturbance; 3, enlargement of the thyroïd; 4, protrusion of eyeball. As to the mechanism of the disease, the author thinks that the impoverished blood acts on the nerves of the blood vessels themselves. Other writers hold that it is the central organs that are affected. To us it appears that there is just as much actual proof of the one view as of the other. In adopting anæmia as a cause of the disease, we have certainly something more appreciable and definable than the so-called "neurosis." But we believe, that, although anæmia is, as Dr. Begbie and his son have shown, a very constant element in these cases, something more is required to produce

such an odd group of symptoms. In favour of the anæmic theory, it is further remarked that the treatment most beneficial is that of blood impoverishment, the salts of iron, good diet, &c. Benefit may also be obtained from belladonna or atropia, internally and externally. Dr. Begbie observed spleen enlargement in two cases.

Whilst in our opinion neither of these papers have quite settled the pathology of the exophthalmic form of bronchocele, both have contributed to our knowledge of this disease. Dr. Laycock shows his ability in applying the discoveries of physiology to elucidate pathological questions, whilst Dr. W. Begbie fully sustains his reputation as an accurate and profound clinical observer.

ART. II.-A Treatise on Gall-Stones-their Chemistry, Pathology, and Treatment. By J. L. W. THUDICHUM, M.D., &c. Illustrated with Plates.-London, 1863. pp. 323.

THE paper-duty is remitted; printing is not very costly; highly educated young physicians and surgeons abound, by whom practice is wanted; time drags heavily without employment; "cards" and advertisements are forbidden them; papers read before the select few, the conscript fathers of the medical societies, bear little fruit, and pamphlets none at all: ergo, the facility and desirability of publishing a book which may make its author's name a "household word" in connexion with the chosen theme. The determination taken to make a book and practice by it, the aspirant's further course is easy; the well-filled shelves of the great medical libraries, particularly if fortune has cast his lot in London, are open to his explorations, and, with the aid of "systems" and monographs of the well-known and quoted authors and the little-known ones-especially if their wisdom be hidden under the cloak of a foreign tongue-time and industry are the only other conditions required for the purpose. No marvel, therefore, that bookmaking flourishes, particularly on pet subjects, with the public.

We are not so uncharitable as to hurl condemnation on all such monuments of bibliothecal research and industry; for if their constructors be well informed, and gifted with analytical talent and critical acumen, the resultant works are often of service, particularly to the busy practitioner and hard-working student, who have neither time nor opportunity to read monographs and weighty original treatises in which the hypotheses and lessons of the handbook are elaborately wrought out and illustrated.

These remarks have been suggested because Dr. Thudichum, like most authors, deems it necessary to explain why he should write upon gall-stones. He rightly attempts no apology for so doing, but affords very satisfactory reasons. His first reason the intrinsic importance of his subject-might be anticipated, but for the second, few, we think, will be prepared, judging from the many books written, the search for topics, and the ardour with which pathological and chemico-patholo