knowledge of this part of practical medicine, and he greatly simplifies the whole subject. The definitions of the various orders are skilfully framed, and a knowledge of these rightly applied supplies the diagnosis. We admit, with Professor Bennett, that an artificial classification is indispensable in the present state of our knowledge, and that it is the only one which can bring the student into acquaintance with the multifarious forms of these diseases. Under the head of Treatment, may be mentioned the plan of local dressing by weak alkaline solutions, which in cases of vesicular and pustular affections have proved eminently useful. A good account of the dermatozoa and dermatophytes is here given; and also an excellent history of favus, illustrated by capital woodcuts. Section 10 treats of Diseases of the Blood. Leucocythæmia, as we might expect, is fully treated of. We have in a former number (vol. x.) exposed the author's views on this subject. We are informed that since the publication of his monograph in 1851, eighteen additional cases of this disease have come under his notice. In one of these the diagnosis was formed from the condition of the blood, there being a difference of opinion as to whether the disease was splenic or ovarian. The disease hitherto called pyæmia, Professor Bennett calls ichoræmia, after Virchow. He shows by facts and experiments that the mere mixture of pus with blood does not occasion the disorder, but that it depends upon a morbid poison. He says: "The so-called pus-corpuscles which by some have been seen in the blood, are identical with the colourless cells of that fluid, and, if in excess, constitute white cell-blood. What has been called pyæmia is not dependent on pus-cells mingling with the blood, but on a matter derived from some kinds of pus which poisons the blood and occasions the secondary phenomena." (p. 852.) Under the head of 'Glucohæmia, our author gives an analysis of the modern views on diabetes, and especially those of Bernard, Frerichs, and others. He also points to the importance of the observations made by Virchow, Busk, Carter, and others, as to the existence and even wide diffusion of starch-corpuscles throughout the animal economy. We find that in Professor Bennett's hands, as in many others, the quinine treatment of continued fever, proposed by Dr. Dundas, of Liverpool, has proved a failure. His cases were carefully noted, and appear decisive of the impotence of the remedy. In his chapter on Syphilis he shows himself to be an uncompromising enemy of mercury as a remedy for the disease. Alas! when shall there arise amongst doctors consonating opinions? When, rather, shall there cease to be such utter dissonance in opinion on matters of fact? Here, mercury is the physician's sheetanchor in syphilis; there, he avoids its use in the same disease as a hateful poison! Such lessons should teach us at all events to bear kindly with each other's sentiments. A chapter on the ethics of medicine brings this excellent work to its close. We cannot shut the volume without congratulating the profession and the author on the publication of it. Its appearance seems to us to mark a new era in medicine-a starting-point from whence we may hope to march onwards, guided by the light of true science. Thus prosecuting our researches, we must arrive at last at something like unity of intention in the practice of our art, and thus experience will be brought into proper unison with theory. If we look back into the history of medicine, we find that at every period there have existed grave dissensions among the practitioners of our art, respecting the methods of curing diseases. A continual series of perturbations, both in the theories and the practices of successive generations, are to be found recorded on its pages. Faith and Scepticism are here discovered at their work, the one asserting its uncompromising and unreasoning trust in the principles inculcated by authority, and the other indiscriminately rejecting the venerable and dusty records of the past, their rare truths and many errors, and asserting its sweeping and equally irrational disbelief in every fact which is not plain to its comprehension. Here we see the practitioner evoking his principles of practice from the consideration of his theory of medicine; and there again we find him rejecting all the theory, and deducing his practice from the results of his experience: in both cases relying with unswerving confidence on his chosen authority, never deeming it necessary to reckon up the value either of the theory or of the experi ment in which he had put his trust. Legitimate medicine has thus been incessantly occupied with intestine struggles. From the earliest days of the art down to our own, the patrons of Theory and the patrons of Experience have been continually on antagonistic terms, fighting their ineffectual battles. One after another, the elaborate systems worked out by them-at how much cost of wasted intellect?-have crumbled away under the weight of their own unworthiness. One after another, the idols of the Man and the Moment have been erected, worshipped, and have passed away, or remain but as memorials of his ill-directed genius. As the Poet Laureate sings "Our little systems have their day, But still, amidst all these ruins of intelligence which surround and overshadow it, the great art of medicine has abided. Amidst all these aberrations of intellect, all these false deductions, and false practices, and false systems, the edifice still stands firm and erect-nay, it has gained strength and purpose from them; it has passed through its dark ages and its many trials with honour and with triumph; bright gleams of light there are which mark its progress onwards, even through the darkest of its passages. Signals of continual advance are indelibly inscribed on the pages of its history, monuments of truth and real nobility, and of the honest intention of its cultivators. This struggling life of medicine we might liken to the bark of Columbus, casting forth into unknown regions, beaten about by difficult seas, tossed hither and thither, the sport of every passing gale, at times threatened with destruction in the whirlpool, sometimes likely to perish through the weakness or folly of those who directed it, or steering wildly, without landmark to guide its course. But still that bark held on its way; still, amidst its temporary retrocessions and its deviations from the right path, it steadily progressed towards the land of promise and of hope. And why? Because there was a master genius, a true man on board, presiding over its movements. And thus has it been with medicine. It has within it a soul of real truth and goodness, which through all these many ages of trouble and of trial has guided and supported it onwards, bringing it still out of its errors and its difficulties. We need not despair of our art. It still flourishes, despite of its own errors and of the villanous trickeries, which, under its name, ever have been and still are palmed off upon the credulous masses of mankind. Honest and true men are busy repairing and beautifying the edifice. A greater light has been thrown over the study of medicine during the last half century than has beamed upon it through the thousand previous years of its existence; and we may now look forward with sanguine hope to its true and scientific development. No higher praise can be bestowed upon a physician than this,-that he has assisted in this development, in the true advancement of his profession, that he has laboured successfully in the cause of humanity and of science, and such praise we unhesitatingly accord to Professor Bennett. REVIEW VII. Observations on Naval Hygiene and Scurvy, more particularly as the latter appeared during a Polar Voyage. By ALEXANDER ARMSTRONG, M.D., R.N. London, 1858. 8vo, pp. 117. FROM the period of the discovery, or more correctly of the adoption of the mariner's compass, and the consequent extension of maritime enterprise from mere coasting voyages to distant seas, and eventually to the circumnavigation of the globe, scurvy a disease known to have prevailed from the most remote antiquity on land-continued, until within a comparatively recent time, to be the especial scourge of the fleets and mercantile marine of Europe. Until the year 1796, scurvy had baffled and discomfited most important expeditions; it had sent back, covered with humiliation, commanders who otherwise would have returned with the laurels of victory; it had kept our ships lying powerless at anchor while our coasts were being menaced and insulted by the enemy; and even so late as during the last ten years of the past century, it had on more than one occasion not only crippled the efficiency, but had endangered the very existence of our Channel fleet. The history of scurvy, indeed, not only occupies a melancholy page in our naval records, but it further affords a remarkable illustration of the difficulties and delays that obstruct and retard the progress and adoption of practical truth. It is undeniable that during upwards of two centuries, the naval annals of which are rife of the ravages and disasters of this scourge, we were in possession of a known means, not only of its cure, but also of its prevention, for a period beyond that usually necessary for the longest voyages. Rousseus, who wrote on Scurvy in 1564, remarks that seamen in long voyages cured themselves of this disorder by the use of oranges. Albertus, in 1593, recommended for the cure of scurvy "the juices of acid, austere fruits, such as oranges." The voyage to India of Lancaster,§ in 1600, demonstrated that scurvy could be prevented by lemon-juice as clearly as did the celebrated voyage of the Suffolk nearly two hundred years afterwards. Woodall, who was Surgeon of St. Bartholomew's Hospital, and Surgeon-General to the East India Company, declared, in 1636, that the virtues of lemon-juice were superior to those of all other remedies in scurvy. From the early part of the sixteenth century, numerous works on Scurvy by authors of note have appeared in various parts of Europe, accurately describing the causes, symptoms, treatment, and prevention of scurvy. Among those who wrote on this disease during the last century, the names of It is not generally known that Admiral Blake, one of Britain's best and bravest naval commanders, was compelled to leave his fleet and go on shore, sick with fever and scurvy," at a most momentous period of his command in the Channel, and leave Penn, Lawson, and Monk to achieve that great and final victory over the Dutch, in which his renowned antagonist and rival, Van Tromp, was slain, and from which may be dated the real supremacy of our naval power. Baldwini Roussei de Magnis Hippocratis lienibus, Pliniique Stomacace ac Sceletyrbe, seu vulgo dicto Scorbutico, Commentarius. 1564. Scorbuti historia proposita in publicum. A Solomon Alberto. In 1600, Commodore Lancaster sailed from England on the 2nd of April with a squadron of four ships-viz., the Dragon, having 202 men; the Hector, 108 men; the Susan, 82 men; and the Ascension, 82 men; for the purpose of establishing the East India Company. On the 1st of August they arrived at Saldanha Bay, Cape of Good Hope, with the crew of the commodore in good health, while those of the other ships were so disabled by sickness and scurvy, that the commodore was obliged to assist them in lowering their sails and hoisting out their boats. The ships of the small squadron were in every respect similarly victualled, with this important exception, that the commodore's crew had administered to them, during the voyage, three table-spoonfuls of lime-juice daily. The Suffolk sailed from England on the 2nd of April, 1794; she had a supply of lemon-juice sufficient to serve out two-thirds of a liquid ounce daily to each man on board. She arrived in Madras Roads on the 11th of September without losing a man, with only fifteen men on the sick list, and none of them affected with scurvy. She was twenty-three weeks and one day on the passage without having any communication with the land. The use of lemon-juice is a precious medicine, and well tried, being sound and good. Let it have the chief place, for it well deserves it. It is to be taken each morning, two or three spoonfuls, and fast after it two hours; end if you add one-table-spoonful aqua vitæ thereto, to a cold stomach, it is the better. Some chirurgeons also give this juice daily to their men, as a preservative, which course is good, if they have store." He adds: "I dare not write how good a sauce it is at meat, lest the chief in the ship should waste it in the great cabin to save vinegar.”— Woodall's Surgeon's Mate, p. 165. Lind, Blane, and Trotter stand pre-eminent; and it is mainly to those distinguished men that we owe the introduction of lime-juice into our navy, and the adoption of those sanitary regulations which have bestowed upon our seamen a degree of health enjoyed by no other class of the community. In 1753, Dr. Lind (whom Sir Gilbert Blane has worthily designated the father of nautical medicine), then physician of the great naval hospital at Haslar, published his celebrated Treatise on Scurvy. This work, which everywhere bears the stamp of great learning, industry, and research, as well as of vast personal observation of the disease, may be regarded as containing the essence of all that has been known of scurvy since the most remote time. The proofs of the prophylactic and curative power of fresh vegetables and lime-juice in scurvy, drawn from a great variety of sources, are here set forth with irresistible clearness and force. "It would indeed," says Lind, "be happy for mankind if in all the various calamities and distresses to which they are subject, the means of relief were so well ascertained as they are in this painful disease."* Sir Gilbert Blane, physician to the fleet in the West Indies from 1780 to 1783, submitted, in 1781, a memorial to the Lords of the Admiralty, containing suggestions for preventing sickness and mortality among his Majesty's seamen in the West Indies," in which he states "that scurvy is one of the principal diseases with which our seamen are affected, and that this may infallibly be prevented or cured by vegetables and fruits, particularly oranges and lemons, or limes." Sir Gilbert had a high opinion of wine as an antiscorbutic, and he recommended its substitution for rum as an article of victualling in the fleet. We may here observe that during the blockade of the River Plate, in 1845, by the French and British squadrons, the latter suffered much from scurvy, while the former enjoyed an almost complete immunity from the scourge, owing mainly, as has been shown by Dr. Bryson, to their having a daily ration of red wine, while the English sailors had their usual allowance of rum.f In Captain Collinson's ship, the Enterprise, wine was issued to the crew instead of spirits, and with great advantage. For the noble part that he took in urging those measures which led to the extinction of scurvy from the navy, as well as for effecting other important sanitary and administrative reforms in naval hospitals and fleets, this country owes much to the able, energetic, and ill-rewarded Dr. Trotter, physician to the fleet under Lord Howe, and author of Medicina Nautica,' and other well-known works. In his official capacity with the fleet at Spithead, in 1794-5, he had the constant pain and mortification to see squadrons returning to that anchorage, unable to keep at sea from the prevalence of scurvy among the crews of the ships. He carries our sympathies along with him when, with the enthusiasm of a patriot and philanthropist, and the earnest reasoning of a philosopher, he laments the terrible effect upon the vast number of seamen then under his care of the severe winter, which, by raising the price of vegetables and beef, led the Victualling Board to limit the issue to the fleet of those articles so essential to health, to one day in the week, with the result of inducing an outbreak of scurvy so severe as to endanger the safety of the Channel fleet. In the same spirit of humanity, we find him scouring the gardens round Portsmouth and Gosport for vegetables, and raising by subscription a few guineas among the officers wherewith to purchase oranges and lemons for the sick. When he tells us that the officers resigned their stock of poultry for the use of the sick and wounded of the fleet after the action of the 1st of June, 1794, the noble-hearted man says, "My heart warms with indescribable emotion while I relate a fact that deserves to be recorded with the pen of an angel." Treatise on Scurvy, p. 544. + On the respective Value of Lime-Juice, Citric Acid, and Nitrate of Potash, in the Cure of Scurvy. By Dr. Bryson: Medical Times, vol. xxi. No. 559, p. 435. "It was observed that when the custom of drinking wine more freely was introduced into Holland, this distemper became less frequent. (Bruneri, Tract. de Scorbuto.) And among the first cures recommended to the world was wine with wormwood infused in it,' (Part iii. chap. 1-Olaus Magnus.)”— Lind on Seurvy, p. 177. Medicina Nautica, p. 78 An application which Dr. Trotter made about this time to the Admiralty, urging the necessity of supplying the fleet with an increased allowance of fresh provisions, pickles, lime-juice, &c., was less successful. His letter was referred by their lordships to the Commissioners of Victualling, by whom, after due consideration, the whole supply, with the exception of some molasses, was disapproved. Those who seek to excuse or to palliate the evils which red-tapeism inflicted upon our army during the late war with Russia, can at least plead that we are not essentially a military nation, and that we had long been unused to war. But it could not be urged at the latter end of the last century that we were not essentially a maritime power, or that we had been otherwise than well accustomed to naval warfare. Impartial truth compels us to record that the same baneful influence which in our day was so prejudicial to our forces in the Crimea, was at the period of which we speak a main cause of much discontent, and of much destruction of human life. In 1795 a Medical Board for the navy was instituted by Earl Spencer, then at the head of the Admiralty, of which Dr. Blair and Sir Gilbert Blane were appointed physicians; and it was through their representation, grounded upon the overwhelming amount of proof in Dr. Lind's work, and the powerful advocacy of Dr. Trotter in favour of the efficacy of lime-juice in scurvy, confirmed by the results of the voyage of the Suffolk in the previous year, that this article was included in the regular victualling of the British Navy. From that time, although scurvy has from time to time appeared in gaols and among troops on shore-as in India, at the Cape, and in the Crimea-is to be dated the extinction, practically, of this scourge in our fleets. To use the words of Dr. Armstrong: "From this period a new era dawned on our navy. The health of our seamen became wonderfully improved, and the efficiency of our fleets was greatly increased, when it was found that ships could keep the sea for any length of time, although deprived of that kind of diet, the want of which had been hitherto attended with such disastrous results. This happy state of things, which has contributed so much to the efficiency of our navy, and to the greatness and prosperity of our country, became established by the introduction of lemon-juice and its judicious employment as a means for the prevention and cure of a disease that had previously been the dread of sailors, and the scourge of the sea. "From this period, therefore, scurvy gradually disappeared from the navy of Great Britain, and is now seldom or never seen in the ordinary course of service; indeed it should never appear, if proper precautionary means were adopted, and if due discretion and judgment were exercised in using an agent of such undoubted power and efficacy, as long experience has proved lemon-juice to be, in the prevention and cure of scorbutic disease. "Since the disease has, therefore, I may say, almost disappeared from the navy, it is only to the history of the Polar voyages that we must look for the record of its occurrence. If, by preventing or curing a most destructive malady, a simple but powerful antiscorbutic has enabled us to circumnavigate the world with safety, it has likewise, by the same beneficial agency, enabled us to establish the greatest maritime discovery of the age, the long sought-for 'North-west Passage,' and thus to enlarge the limits of our empire, by the discovery of vast territories in the hitherto unknown regions of the pole." (pp. 5, 6.) As concurring in an eminent degree with the supply of lime-juice to raise the health of the navy to its present high standard, due weight must be given to the new scale of provisions introduced about the beginning of the present century-improved in quality as well as in quantity; the great attention given to a proper internal economy on board ships; the substitution of iron tanks for water-casks; the establishment of sick bay messes; and other hygienic measures, that have from time to time been adopted. The means taken to promote the mental culture of the seamen have also contributed in no inconsiderable degree to effect the revolution that has taken place in the sanitary state of the navy. "Hilarity and cheerfulness," Dr. Armstrong well describes, are "the great moral antagonists to disease." The voyage of Captain Cook in the years 1772-5 is commonly, and most justly, put in favourable contrast with that of Lord Anson, which preceded it by little more than thirty years. Cook's ship, the Resolution, with a crew of |