the medulla oblongata, and upper part of the spinal cord, where the slightest alteration appears to be incompatible with life. Several microscopical sections of the morbid changes in these centres were shown at the Pathological Society, London, in 1872, by Dr. Clifford Allbutt. give them a bath. The latter symptom is not, however, constant; some patients are able to drink during the course of the disease, when even a loud voice or bright light will throw them into the most horrible convulsions. These paroxysms, which recur under the influence of the slightest cause, present themselves with a truly fearful intensity; the whole body becomes rigid for some seconds, and then ensues a succession of violent jerks and spasms strong enough to break almost any controlling bonds, and the head and limbs are bruised against the walls. In the intervals a continual spitting is observed, which may be equally due to the spasm preventing the saliva from being swallowed, and the augmentation and alteration of the salivary secretion, which may become a true lather (bave). The pupils are dilated, the eye sunk and brilliant, sleep incessantly disturbed or wanting. Some cases are troubled with a very marked venereal excitement. It is extremely rare to see that anxiety to bite which renders the approach to such cases so formidable in the eyes of the vulgar. Some cases are gloomy and restless, only speaking briefly at rare intervals, and, giving themselves up to continual terrors, show a true panophobia; in others the sentiments of affection persist and are augmented. As the disease makes progress the attacks of spasm repeat themselves with increasing violence, the more cruel because intelligence often remains intact to the last. The continuity of the paroxysms does not fail to exhaust the strength, the ideas become confused, the anxiety increases; in some cases the eyelids retract and the eyes protrude, the body is suffused with perspiration, and if(2) increasing irritability throughout the cord. death does not take place suddenly in the midst of a convulsion at an early stage, it does so towards the third or fourth day. Death is the constant termination of hydrophobia. The duration of the disease in 161 cases in which it could be exactly ascertained was as follows: "The specimens were taken from the cere bral convolutions, from the central ganglia, the medulla oblongata, and the cord. Throughout all these centres were found the same morbid conditions, but in different degrees, and these were as follows: 1. Evidences of great vascu lar congestion, with transudation into the surrounding tissues. In all the grey centres the vessels were seen in various degrees of distension, their walls in many cases being obviously thickened, and here and there were stel patches of nuclear proliferation. There was a diminished consistence of some of the parts, particularly of the medulla. This seemed to be due to serous infiltration and soddening. 2. Hæmorrhages of various size, and in many places a refracting material visible outside the vessels, due apparently to coagulate fibrirous exudation. 3. Little gaps, caused by the disappearance of nerve-strands, which had passed through the granular disintegration of Clarke. In addition to these appearances in the nervous centres, an enlarged spleen had been found in both cases. The parts seemed to be affected in the following order as regards severity (1) medulla, (2) the cord, (3) the cerebral convolutions, and (4) central ganglia. This was in accordance with the symptoms during life-viz., (1) reflex irritability in the region of the medulla, with no tetanic spasms with semi-tetanus; (3) delirium.”—(Lancet, 1872, vol. i. p. 82.) Hydrophobia in man is always the result of contagion, operating only by one direct and immediate way-the inoculation of the rabid virus by domestic or wild animals--and the only vehicle is the bare or saliva which they deposit in the wound. It has been proved that neither the flesh nor the milk of a mad animal exercises ALY contagious action. Although hydroph sis may be transmitted from carnivorous animals to the herbivorous, and from the latter to others of the same species, it does not app that the last have the power to communicate it to man. After several successive transmis sions, the faculty of contagion appears to be exhausted even in the dog. Hydrophobia is said to be not communicati from man to man. The cohabitation of a tr affected with rabies with a woman does 14 communicate it. There are recorded one two instances in which inoculation of ani with the saliva of a hydrophobic patient had less cauterisation is effected immediately, or given the disease. very soon after the injury, it is useless. The virus only acts on denuded surfaces. It is not certain whether it can be absorbed by mucous membranes, but it may be presumed possible. All persons are not equally liable to be affected, "for only ninety-four persons are known to have died out of one hundred and fifty-three bitten, making the chances of escape as three to one nearly."-(AITKEN.) There would appear to be a few predisposing influences, such as all circumstances which depress the mind or body. The season of the year has also evidently an influence; in 181 cases occurring in France 66 were in June, July, and August. 44 40 31 March, April, and May. December, January, and February. Or, dividing the year into two parts, there were 110 cases in the hot seasons, and only 71 in the cold seasons. In 115 fatal cases the methods of prevention were noted-i.e., whether the wound was cauterised sufficiently or not. condemned. Prevention. The only method of prevention known is the removal of all causes likely Hygiène Hygiène is the art of preservto dispose dogs to receive the disease. They ing health, of prolonging life, and of showing should be frequently washed, have good food, how the human species may be perpetuated opportunities for exercising their natural ap- and developed in the greatest perfection. It petites, and a strict watch kept by the police is naturally divided into private and public on vagrant dogs. The raids made from time-private, when it relates to the individual; to time in London are required all over the public, when it deals with masses of men. country. All unowned dogs should be de- Public Hygiène.-The comprehensive aim stroyed, and every case of canine madness and scope of public hygiène cannot be better reported to the medical officers of health in expressed than in the words of Dr. Guy: “It the district, who would then have an opportu- has to do with persons of every rank, of both nity, through the sanitary authority, of taking sexes, of every age. It takes cognisance of the the necessary measures. In cases of actual places and houses in which they live; of their bite, the person attacked should if possible occupation and modes of life; of the food they immediately suck the wound, and if assistance eat, the water they drink, the air they breathe. is at hand, have it cauterised. No one should It follows the child to school; the labourer wait for the arrival of a medical man, but if artisan into the field, the mine, the factory, the wound is small, either cut it out or apply the workshop; the sick man into the hospital; a red-hot iron at once, or use both cauterisa-the pauper into the workhouse; the lunatic tion and excision, if, as in some cases, there to the asylum; the thief to the prison. It is is no doubt of the madness of the dog. Let with the sailor in his ship, the soldier in his no foolish feeling of ill-directed mercy influ- barrack, and it accompanies the emigrant to ence the bystanders. Many a poor wretch his new home beyond the seas. To all these who has died one of the most awful of deaths it makes application of a knowledge remarkwould have been saved by a little instant de-able for its amount, and the great variety of eision. In many cases, however, the person is bit on the ance cannot be had. If the part bitten is one of the extremities, after sucking well, a tight string placed above the injury would appear to be likely to prevent absorption, at all events, until the sufferer could reach some place of help; but if in the face or buttock, trust must be placed, under such untoward circumwashing the wound in the nearest rivulet or stances, in encouraging the blood to flow, and puddle. It is greatly to be feared that un sources whence it is derived. To physiology and medicine it is indebted for what it knows of health and disease; it levies large contribu tions on chemistry, geology, and meteorology; it co-operates with the architect and engineer; its work commends itself to the moralist and divine." (Dr. GUY, Public Health, 1874.) There have been treatises on hygiène from the very earliest times, which Hippocrates is supposed to have embodied in his works; but as a science it cannot be said to have existed until a comparatively modern epoch, for it is a science that is based on the researches and discoveries of physiologists, and actual statistics. It would be impossible for the legislator to make efficient laws, or the sanitary engineer to carry out his designs effectually, without its aid. In England the science may be said to have begun with the rude measures of prevention in the time of the plagues and murderous epidemics of past times; to have shown its power when Howard purified the jails, when Jenner conquered smallpox, and Sir George Baker discovered the cause of Devonshire colic; and to have definitely taken its position as a branch of study recognised by the State, when the first great and comprehensive measure, the groundwork of sanitary legislation, was passed -viz., the Public Health Act of 1848. Its study and practical application have done, and are doing, 'great things in our armies, navies, factories, and workshops. The Legislature is at last thoroughly alive to its importance, and its future may be looked to as of the brightest character. It is to be confidently expected that the present Public Health Act of 1875 will be greatly amended, its faults and deficiencies corrected, that the prevention of disease will not be a theory but an accomplished fact, and that the twin goddesses of Health and Knowledge will at last bestow their untold blessings on the land. Private Hygiène.-There are certain general principles which are applicable to all menthat they should have sufficient pure air and water; that they should live in healthy houses, follow occupations which are not injurious, be cleanly in habits, be moderate and abstemious in all things, wear suitable clothing, and eat a sufficiently plentiful and nourishing diet. And, again, there are certain principles applicable to the individual only which no universal rule can embrace. One man had better abstain entirely from alcoholic liquors; another requires a slight stimulant. A certain food is so much poison to one, while others eat it with impunity. Thus, "Know thyself" should be written on every door; and a knowledge of that self is to be obtained, not by a nervous and apprehensive curiosity regarding all that goes on within the body of the individual, but by an intelligent and sensible observation of the causes, whether internal or external, physical or emotional, which have injuriously affected him, and a knowledge of the past medical history of his ancestors. If every man handed down to his children a chronicle of his ailments, with their causes, as corrected and revised by his physician, although in many cases, it is to be feared, it would be a humiliating and painful record, yet it would be of the greatest use to the in dividual who has inherited the same features, passions, and predispositions. It is, however, impossible here to enlarge upon the subject of hygiène generally, since every article in this book bears upon and is included in the subject. Hygiène, Military- This subject is too large to be fully treated here. The reader is referred to Dr. Parkes' "Hygiène" as the best book in our language, and to the "Handbuch der Militär - Gesundheitspflege," by Dr. W. Roth and Dr. R. Lex. Berlin, 1872. Military hygiène deals with all that bears upon the health of the soldier-his food, his clothing, his dwelling, his occupations, &c. All army surgeons and writers on military hygiène unite in stating, as the result of their experience, that the age of the recruit as at present fixed is too low, and propose twenty years of age as the minimum. Indeed, the events of the late war have strengthened the opinion which a former study of physiology and the laws of growth naturally led to-viz., that the recruit of eighteen is decidedly immature. The Army of the Loire, composed of very young men, melted away before the trained German soldier. Men of twenty-seven and thirty can stand fatigue, insufficient food, and all the changes of climate far better than young lads. Military service is, and always will be, even in peace, somewhat arduous to the recruit. Michel Levy, in "Traité d'Hygiène Pub │lique," writing ten years ago, says: "In time of peace, for drilling exercise, the soldier is called early in the summer mornings, and undergoes the fatigue of monotonous attitudes, too long exposed to the sun, wind, and dust. These exercises often become laborious, as they are more frequent and prolonged at the approach of reviews and general inspections. Then come marches, parades, evolutions, sham combats, gymnastic exercises, keeping guard, sentry duty, picquets, and patrols, which expose the soldier to the night air (according to Marshal Soult (1842), the mean of the guard-nights for the French soldier is from two to five); and all this without mentioning a number of other labours -the frequent migrations of the garrison at short intervals for troops of the line, adding the dangers of change of climate to the fatigue of a march. In time of war the soldier accomplishes great distances, passes into distant climates, embarks for voyages more or less long in ships nearly always crowded, executes forced marches, fights by day, bivouacs by night, camps beneath tents or in barracks which imperfectly shelter him against the rain, cold, and heat, endures hunger and thirst, and undergoes in ambulances and ten porary hospitals the deleterious influences of overcrowding. What is the result of the sum of these influences? Disregarding the exceptional mortality of battle, the deaths in the army in men from twenty to thirty years are, according to M. Benoiston de Chateauneuf, 225 per 1000, but according to official documents still higher-e.g., in 1825 it was 27·2— while among the civil population the deaths in men of the same age are 12.5 per 1000. These figures are the more disproportionate, because they are furnished by men chosen in the flower of their age; they are not explained by an increase of mortality resulting from duels, suicide, nostalgia, syphilis, and celibacy, which are only secondary influences. There are two principal causes of the mortality of the army the sudden changes of climate, and the fatigue of the daily exercises ie, of the manoeuvres, parades, frequent watches, &c.; that is to say, an expenditure of force goes on which exceeds the powers of the constitution and that of the alimentary reparation. Thus we see the powerful action of the degree of labour-the mortality is less for the sub-officer than for the soldier, and less for the officer than for the sub-officer. In England the mortality of the whole army is estimated at 17 per 1000, and at 12 per 1000 for officers. In France it is 19 for the army, 108 for officers, and 22-3 for soldiers only. The passing into different climates and war augments the mortality. Thus the French troops in the Antilles lost 75 per 1000, in Algeria 70, and in Egypt 69. In the Spanish war, disease alone carried off officers at the rate of 37, and soldiers at the rate of 119 per 1000," Since that time there has been, however, a general improvement in the health of the soldier. For example, the last army report (1871) gives the following instructive table: United States, before the war and compares the decrease of the mortality Dr. Parkes ascribes the improvement to the great reforms in the army with which the name of Lord Herbert is associated, and observes, as a curious fact, that the mortality of the French and English armies is now almost the same-viz., about 95 per 1000 with the colours-slightly lower, however, in the English army. The causes of mortality may be gathered from the following table, calculated out by Dr. Parkes, from Appendix I. in Dr. Balfour's Report on the Army Medical Department Blue-Books (1859-71) :Causes of Mortality. Loss per 1000 by-- system.. chiefly enteric... 1871. 1870. Such a result is in the highest degree satisfactory, and tends to produce a confidence in sanitary measures. We will now shortly consider the food, clothing, and habitations of the soldier. The Food of the Soldier.--One of the great difficulties in war is to provide proper food, and in peace as well as in war to keep men from taking too much alcohol. One of the first principles in the diet of the soldier is that he should have in actual field-work very little alcohol. General Grant prohibited absolutely the use of spirits in camp by his soldiers and officers, and the result was a most marked improvement in the health of both classes. In the details given under ALCOHOL it will be seen that there is ample proof of its inutility as a diet, as a heat-giver, and as a supporter of muscular exertion. That it may be required to give a temporary fillip in cases of emergency, is quite possible-the pedestrian who walks a hundred miles in a hundred consecutive hours, towards the end of the course urges on his flagging heart by a few mouthfuls of champagne. For the general diets of soldiers, see RATIONS. In time of war, the great thing is to so vary the food of the soldier as to keep off the ravages of the scurvy. The use of fresh vegetables, fruits, &c., is essential, but not always to be obtained in sufficient or regular supply. Condensed foods, meat extracts, biscuits, and the German pea-sausage are required for quick movements; but despite the inventive ingenuity of preservers of meat, &c., no really good portable and compact food has yet been brought forward suitable for the soldier in such cases. The clothing of the soldier has excited much attention; it is evident that it ought to vary according to the climate in which he is employed. It would be, indeed, well to copy to a certain extent the costume of the nation against which he is engaged-to wear the sandal on the hot Eastern plains, to wrap himself up in sheepskins in Siberian snows, and, generally speaking, to adapt his costume to what the experience of the natives has shown to be the best. We still load some of our soldiers with heavy, hot helmets, cramp their necks with stiff stocks, and injure their chests with tight garments. "The clothing of the soldier should be selected sufficiently loose to permit the neck and chest to be at ease; the trousers should not press too tightly over the stomach." On entering upon active service, the clothing should be new, or nearly so, the shoes well fitting, and the soldier should have two flannel binders. The cavalry should, moreover, use a suspensor, a precaution the advantage of which is apparent. Up till now the use of waterproof material has not been authorised, although during the late war such officers and men of the various contingents as were able to provide themselves with it did so, and in the regular army officers are recommended to provide themselves with two flannel shirts and a waterproof cloak. The greatcoat used by the men is of sufficiently good material to be to some extent proof against the admission | of wet. A few of the general regulations on the subject of clothing may, in conclusion, be given. Thus, "It should, above all, have the preservation of health as the first object; all intended for parade, and which adds useless weight to either officers or men, should be suppressed; that only should be retained in which he can at any time march against the enemy."(Lessons on Hygiène and Surgery from the Franco-Prussian War, by C. A. GORDON, M.D., C.B.) Next in importance to clothing and diet comes the habitation of the soldier-in times of peace lodged in barracks (see BARRACKS), in times of war in tents, huts, or wherever he can be located. "In the densely-peopled towns or villages which soldiers are so often constrained to occupy, the soil beneath the houses and around them is often reeking with corruption, sodden with the damp products of decay; and these not only become parents of fever and nurses of all sorts of pestilential maladies by polluting the air, but also, as we know, by poisoning the waters of wells or streams with the seeds of dysentery, cholera, and typhoid fever, and probably of every form of contagious malady.” -(Dr. W. A. GUY, Public Health.) Overcrowding in war always prevails more or less. It is not alone too many in one tent, or too many tents on a given spot of ground, but there is a novel form of overcrowding introduced-namely, an overcrowding on the Hygiène, Naval-The total force serving in her Majesty's ships amounts to about 47,640 men. The merchant navy is manned with about 327,000 hands, and we may reckon (according to the returns of the Emigration Commissioners, 1872) that about 300,000 persons annually leave the shores of the United Kingdom. Add to these figures men employed on coasting vessels, barges, and other craft, and it will be seen that sanitary science afloat cannot deal with less than half a mil lion men, hence its importance. The Navy.-The ravages that all kinds of diseases, and especially scurvy, formerly made in our navy is a matter of history. Sanitary progress in this department has been slow-c.g., lemon-juice was supplied to merchant ships as early as 1617, but was actually not introduced into the navy until |