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XII. Influenza comes under notice. The article on this disease commences with a most elaborate chronological table of all the epidemics which have occurred from the year 1510 downwards, and concludes with an equally elaborate bibliography of the literature bearing upon the subject. There are many observations given to prove that epidemics of the disease have appeared under all conditions of season, and consequently that its origin and propagation are quite independent of all known atmospheric influences.
The work of Hirsch is truly a most valuable contribution to medical literature, and must henceforth be regarded as the great authority upon everything having reference to the geographical distribution of disease. We shall hail with much pleasure the appearance of the two remaining volumes.
We regret that we cannot speak in terms of equal praise of the two other works now before us. That of Mr. Craig has been written with the object of proving that the great cause of epidemic and many other diseases is to be looked for in the variations of electric tension, and that such causes as contagion and miasmata exist only in the minds of medical theorists. The work contains few or no results of the author's personal observation, but the observations of many others have been carefully collected to bear out his reasoning. In many instances these observations would quite as readily admit of another explanation than that which is here given to them, while in some parts of the work there are assumptions which, to say the least, are most gratuitous. For example, we still require something more than the mere assertions of the author to convince us that nervous force and the electricity evolved during galvanic action are one and the same. The whole argument of the work is founded upon these principles:
"That electricity and nervous force are identical, that the electricity evolved from the air in the lungs during respiration, and that separated from the ingesta during assimilation, is that which supplies the vital electricity to the nervous system, and that any cause which hinders the supply, or suddenly and to a great extent withdraws it after being supplied, will injuriously affect the system." (p. 43.)
This withdrawal of vital electricity is thought first to affect the nervous system, and through this, the blood and solid tissues. Epidemic and endemic diseases, we are told, are most prevalent in damp places, because moisture is a good conductor of electricity. But not only is it asserted that nervous force and electricity are identical, it is necessary for the author's argument to maintain that caloric and electricity are also identical—" merely different manifestations of the same element." (pp. 193 and 221.) Now, it would be out of place here to enter into such an intricate question as the abstract nature of heat and electricity, but we do insist that in the present state of science the author is not justified in making the assertion that "caloric and electricity are identical," without a single fresh fact or observation in support of the assertion, and still less to base upon such a groundless foundation a theory of the origin of disease.
Again, if all diseases mentioned by the author originate from an
abstraction of vital electricity, what, we would ask, constitutes the difference between the causes of each ?-what is it that determines whether the disease is to be plague, cholera, ague, or yellow fever? An attempt is certainly made at one place to account for the difference between plague and yellow fever. We give the author's own words, and we leave our readers to draw their own conclusions as to the sufficiency of the explanation:
"In those regions where yellow fever is endemical, it is the effectual wetting of the dry soil and the hasty drying under a burning sun, that produce the phenomena of this disease. In those regions, on the other hand, which are frequently visited by plague, the wetting is as sudden, and in some places more effectual, but the drying is less rapid but more continuous. In the formermentioned disease, the abstraction of vital electricity is larger, the shock to the system greater and more sudden, and the course of the disease shorter. In the latter disease, the abstraction of vital electricity is not so large in quantity, but is more continuous, and the course of the disease is more protracted. It requires a different amount of agency to produce respectively plague and yellow fever. The land in the unreclaimed regions of the back settlements of North America, with a stiff and unabsorbing condition of its surface, will present a wet expanse to a burning sun, and produce quick evaporation, readily placing the locality in a low state of electric tension, and this negative surface will speedily abstract from the animals in contact with it. On the mud-banks of the Nile, and the other swampy regions of the Levant, there is at certain seasons of the year a slower but more constant evaporation-a more gradual abstraction of vital electricity." (pp. 269-70.)
The plague we have long considered as closely allied in its etiology to the typhus of this country. Indeed, we occasionally see cases of typhus complicated with glandular swellings and abscesses, and so resembling the Eastern plague that a celebrated Egyptian physician some years ago, on seeing them in the London Fever Hospital, declared that in Egypt they would be set down as examples of the latter disease.
The author is rather sparing in his remarks upon the origin of the epidemic diseases of our own country, which, by the way, would seem to be the only ones he has had an opportunity of personally observing. There is one statement, however, under this head, which we cannot allow to pass unnoticed. The epidemic of fever which occurred at Croydon in 1852, is attributed to the abstraction of vital electricity produced by the evaporation consequent on the overflowing of the Bourne spring. Now, this epidemic was an example of the so-called typhoid fever, which clearly owed its origin to the putrid emanations from the drains at that time undergoing repair. We have the most ample evidence upon these points on the authority of some of the ablest physicians and engineers of the day; and we hardly think the author could have committed such an error if he had consulted for information the official documents upon the subject published by the Board of Health, in place of the account contained in a Scotch newspaper.*
Again, with regard to cholera, we are not prepared to attest the statement that there is "a disturbance of the central nervous system, as displayed in deranged sensorial manifestations." The sympathetic system, it is true, may be primarily influenced; but the central nervous
* The Scottish Guardian.
organ and the special senses in most cases remain perfectly unaffected until the last. The author also states, that the inhabitants of houses with wooden and carpeted floors are more exempt from cholera than those of houses with stone floors, and this he attributes to the nonconducting powers of carpet and wood. We doubt if the fact which is thus explained does not in the first place require to be established.
Mr. Craig's work exhibits considerable originality, but is apparently little more than the elaboration of an hypothesis in his own study, the author having had but few opportunities of personally observing the subjects of which he treats. The preface to the book commences by stating, that it ought to be the object of every writer steadily to aim at finding out the truth, and when this has been accomplished, to proclaim it to the world. We very much doubt if the author has established the correctness of his views, and in our opinion their publication in the present form is premature.
The third work on our list is the reprint of a paper which originally appeared in the 'Transactions of the American Medical Association.' The author does not profess to investigate the exciting causes of fevers, but only to search out the laws of their morbid phenomena. Recent researches, we may observe, have shown that the subject of their etiology is scarcely so unpromising as we would conclude from reading Dr. Campbell's statement, that the causes of fevers are "entirely and confessedly beyond our reach and comprehension."
Dr. Campbell's object is to demonstrate, that the nervous system is primarily and principally affected in febrile diseases, or in short, that fevers are essentially diseases of the nervous system. Fevers he considers as divisible into two great classes, the paroxysmal and the continuous. The former he believes to result from some morbid action of the cerebro-spinal nerves, while in the latter the ganglionic system is chiefly affected. Indeed, the whole argument of the work may be summed up in the following fundamental proposition
"As in the nervous system we recognise two grand departments-viz. : 1st. The cerebro-spinal system, all the normal actions of which are subject to cessation and interruption; and 2ndly. The ganglionic system, all the normal actions of which are of a continuous and uninterrupted character, so in the manifestations of febrile diseases do we distinctly recognise two grand distinguishing characteristics, respectively typifying the normal actions of these two systems of nerves. Thus, a character of paroxysm obtains in certain cases, while a character of continuousness as plainly marks the others." (p. 11.)
Cerebro-spinal and ganglionic neuroses consequently constitute the basis of the author's classification. In the former class he includes neuralgia, tetanus, epilepsy, hooping-cough, croup, spasmodic asthma, intermittent fevers, dengue fever, and yellow fever; and under the latter, diarrhoea, cholera, typhoid and typhus fevers, and the various exanthemata.
We make no comment upon the author's views, which, of course, are entirely hypothetical. His work, however, will be found to contain an interesting account of an epidemic of diphtheria, which occurred at Augusta in the autumn of 1848 (p. 76), as also accounts
of several outbreaks of the so-called dengue or breakbone fever (p. 135). The latter deserve especial attention from the fact that the disease is scarcely known to the profession in this country. Diphtheria, as it appeared at Augusta, Dr. Campbell believed to exhibit paroxysmal characters, and to be greatly benefited by antiperiodic treatment, such as the administration of quinine.
1. The Healing Art the Right Hand of the Church. By THERAPEUTES. -Edinburgh, 1859. pp. 279.
2. God in Disease. By JAMES FOULIS DUNCAN, M.D., Fellow of the Royal College of Physicians in Ireland; Physician to Sir P. Dun's and Simpson's Hospitals, &c. Second Edition.-London, 1857. 3. The Soul and Future Life. By THOMAS CROMWELL, M.D.-London, 1859. pp. 307.
4. Man and his Dwelling Place.-London, 1859. pp. 416.
Ir is far more strictly true of scientific subjects than of literary, that they are united by a common bond, and maintained in a certain and close relation to one another. As our own science has been subdivided, and its branches multiplied, its relations have become extended, and its points of contact with other sciences much more close and numerous. Microscopic Anatomy brings us in contact with the whole field of Natural History. Chemistry, refined and subtle to a degree our fathers never conceived possible, and the various medical inquiries connected with sanitary subjects, establish relations with the sciences and the practical arts, that are most nearly concerned both with the destructive energies of war and the progressive improvements of peace. Physiological Psychology cannot ignore the old questions of metaphysics, nor the moral questions now so keenly agitated that refer to the social improvement of our country and the gradual elevation of our race. And lastly, every hour of our life, every speculation on disease, and every effort at its removal, brings us face to face with that grand unsolvable problem, into which all minor difficulties ultimately run up, which throws its inscrutable and gloomy shadow over this beautiful world-the existence of physical and moral evil, under the administration of a Deity infinite in goodness and in power. We trust, therefore, we shall not be considered going out of our way, or beyond our proper limits, if we offer a few remarks on the connexion of our art with those benevolent efforts now made to diffuse the light of science and religion-the two co-ordinate motive powers in the improvement of our species, among the less favoured tribes of our race, and among the outcasts of our own civilization; adverting, at the same time, to the influence which the current philosophical opinions of our time, as exhibited in such works as those whose titles we have placed at the head of this article, must exert both on these efforts and on their connexion with medical science.
In M. Guizot's 'Lectures on Civilization' the author remarks that whenever a man obtains possession of a new and important truth, he is constrained by an impulse more or less irresistible, according to the character of his mind, to become a missionary in its propagation. Now this, and much more than this, results from the moral structure of the human mind; not only are we constrained to diffuse the opinions we hold, but we are equally constrained and equally bound to give practical effect to them. Not only is there a feeling of benevolence in human nature, a separate and independent sentiment, which no amount of ingenuity can explain away or resolve into elements of a purely selfish description; but this sentiment is supported, and sanctioned, and rendered imperative, by the decisions of that faculty, call it conscience, or the moral sense, or what you will, which at once claims, and is felt to claim rightfully, control, superintendence, and direction over the rest. It matters little what account we give of conscience analytically, whether we regard it as a simple and original faculty, or capable of being resolved into yet simpler elements; even on this latter view, the moment these elements are presented to each other, they combine and form one homogeneous power, which claims authority, and has its claims at once conceded. For the truth of this statement we appeal to every man's individual consciousness, and to the nature of the human mind itself, which is evidently a system, as much as any piece of human mechanism, adapted to subserve a particular purpose; and consequently the purposes which its various propensities, affections, and passions are capable of serving, measure and define the extent of our obligations; regard being always had to the supreme authority of the faculty before referred to, in which human nature may be said to culminate. The obligations to benevolent exertion, then, do not arise from positive injunction, but are strictly natural, originating from the nature of man and from the relations in which he is placed, combined with the powers and opportunities which the progressive development of society confers on individuals, bodies of men, or separate nations.
Civilized men have not been slow to take advantage of their great superiority in the arts of war, and the progress of events appears to indicate that the whole of the earth's surface will ultimately fall under the dominion of the energetic and progressive nations of the West, our own restless and acquisitive Anglo-Saxon race appropriating the larger share of it, either by direct conquest, or by the progress of commercial aggrandizement. But the moral obligations resulting from superior power, education, and knowledge, either towards barbarous races of men or defective civilizations, or even towards the Helot tribes of our own kindred and nation, have been slowly acknowledged, and are even still imperfectly and feebly acted on.
While the re
A better day, we believe, however, has risen. searches of science, particularly the sciences of vitality, with which we have to do, are carried on with an ardour, and prosecuted with a success, which half a century ago could not have been conceived; extended views of political economy are clearly and irresistibly