The

in the different vessels, from 38 to 83 per 1000 of their crews. total number invalided was 78, and that of deaths 23. The greater proportion of sickness consisted in venereal diseases 208 cases of syphilis, and 47 of gonorrhoea. Nearly one-half of the former were contracted in the home ports, and at least half the remainder at Valparaiso, where syphilis appears to be more prevalent than at any other sea-port in the Pacific. Of all kinds of fever, there were 134 cases, none of which were fatal.

West Coast of Africa.-The squadron here employed for the suppression of the slave-trade, consisted of twenty-one vessels, from one of which the medical returns have not been received. The mean force, including Kroomen and African boys, amounted to about 1680. The daily average of those inefficient from wounds and sickness, was about 55 per 1000 of mean force. The total number invalided was 74, and that of deaths 30. There is nothing calling for especial observation in the diseases which prevailed; but Dr. Bryson's remarks on the causes which have conduced to the comparative absence of fever of late years, and on its improved treatment, are well worthy of attention. They will be found at p. 115-16.

Cape of Good Hope.-There were only five vessels employed on this station, with a mean force of about 890 men. The total number of deaths was 17, of which 7, or a ratio of 7-8 per 1000 of mean force, were from disease; those from accidents were 10, or in the ratio of 11.2 per 1000. The total number invalided was 36. Considering the unhealthy nature of the coast from Port Natal to Zanzibar, off which the vessels were frequently cruising for months continuously, febrile diseases were of rare occurrence.

East India and China Station. The squadron on this station consisted of twelve vessels, with a mean force of about 3410 men. The ratio of deaths from disease was 26-7, that from wounds, accidents, and causes not known 7.3, in all 34 per 1000 of mean force, a rate which must be regarded as small, when the nature of the Chinese climate, and the duties in which the force was employed, are taken into consideration. The most prevalent disease was diarrhoea, of which there were 969 cases, 2 only fatal. The greatest number of deaths were from dysentery, 48 out of 293 cases. Diseases of the sexual organs were numerous and severe, 441 cases of syphilis, and 179 of gonorrhoea and orchitis. The greater part of these were contracted at Hong-Kong, where syphilis appears to exist in a more than usually virulent form. Of continued and remittent fever there were 448 cases and 11 deaths. Of 242 cases of intermittent fever none were fatal. The total number invalided was 71, and that of deaths 116.

Australian Seas.-There were only five vessels employed in these seas, with a mean force of about 540 men, who enjoyed, as might have been expected from the well-known salubrity of these regions, a high standard of health, whether in port or at sea. The deaths from sickness were in the ratio of only 5.6 per 1000 of mean force. No death occurred from external violence, but six men were drowned by the upsetting of a boat in a squall, making the deaths from accident 11.1

per 1000 of mean force. It happened, however, curiously enough, that while the mortality from disease was less on this station than on any other, the rate of invaliding was greater. This was caused by the appearance of dysentery in one vessel, the Herald, and of epidemic dropsy in another, the Juno; the former is a disease of rare occurrence in any part of Australasia, and the latter is one of which there is no other example in the records of medicine. We here condense the account of the epidemic ascites, which for some time prevailed on board the Juno.

The first case was placed on the sick list in the beginning of January, a short time after the ship had returned to Sydney from a long cruise among the islands of the Pacific. A sporadic case had occurred in May of the preceding year, which did not differ materially in its aspect from those forming the epidemic of 1856. Unlike any of these, however, it terminated fatally. The crew, while at sea, had been healthy, though latterly they had shown a disposition to ulcers, owing, it was supposed, to the long continuance of salt rations. The subject of the first epidemic case, previously a strong, healthy man, was sent to the Military Hospital at Sydney, where he remained for a month, and then joined the ship improved in health; but, beginning soon afterwards to look pale and sallow, and not being likely to recover on board, he was discharged to the military hospital at Hobart Town. On the 3rd of March, two similar cases occurred, which were sent to the military hospital at Sydney, the ship having returned thither. The Juno left Sydney on the 8th of March, and arrived at Hobart Town on the 13th. On the 16th, another case occurred, and another on the 19th. About the same time two more men were attacked; these had previously been suffering from abscess and ulcer. From this date up to the 28th, when the ship sailed for Sydney, one or more cases occurred almost daily, till their number amounted to eighteen. In general, the patients, among whom were a large proportion of the strongest men in the ship, exhibited little or no constitutional disturbance; but their complexion was sallow or pale, and they complained of mental depression, a feeling of uneasiness, and a troublesome barking cough, which had generally existed for some days or weeks previously to the invasion of dropsy.

As no such epidemic was known either at Sydney or Hobart Town, and as there was nothing detrimental to health either in the duties or the diet of the men in the Juno, it was difficult to form any opinion as to the origin of the disease; but, as it was confined to the crew, and the majority of the cases to the same locality in the ship, it was supposed that the exciting cause might exist in the holds, though they were free from offensive effluvia, and appeared to be thoroughly clean. As it was not possible to clear out the hold till the ship returned to Port Jackson, it was thought advisable to cleanse the lower deck. We omit to describe an accumulation of dark slimy matter, which was found under the decayed shot racks, because, as Dr. Bryson truly

* Febrile disturbance we presume is meant, for men with the symptoms mentioned could hardly be said to be free from constitutional disturbance.

observes, similar collections of matter have existed in innumerable instances both in houses and ships, without producing any disease of the nature of that in question. The ship again left Hobart Town for Sydney, which she reached on the 6th of April. Two or three days afterwards the crew were landed, and those who were still in good health went into barracks; the sick were lodged in hospital, and the officers, midshipmen, and warrant officers remained on board. The ship was then cleared of her stores and thoroughly washed, cleansed, and fumigated. Some black slimy matter was found about the keelson and under the limber boards, but not more than is usual under similar circumstances. It did not appear that the persons who were most constantly engaged in cleaning the holds, were attacked in greater numbers than others. Five cases occurred after the crew landed: one on the 16th, one on the 17th, and one on the 19th, 23rd, and 28th respectively. On the 9th and 10th of May, the men returned to the ship. One case occurred on the 9th, one on the 23rd, and one on the 2nd of June, with which the epidemic terminated. Two cases of oedema of the feet occurred in the Fantome, but in no other vessel on the station was there any disease of a dropsical character.

The surgeon of the ship, a most intelligent officer, was of opinion that the source of the disease existed in the accumulation on the lower deck already alluded to; while the assistant-surgeon, in a well-written report, considers the disease as dependent "on causes producing a morbid state of the fluids, which most resembled their condition in scorbutus," though he admits that the former cause may have exerted a predisposing influence. We quite agree with Dr. Bryson as to the inadequacy of both these hypotheses to account for the phenomena.

Irregular Force.-Besides the vessels employed on the several naval stations or commands, there were others employed irregularly, or on special duties, which did not remain for any great length of time in any one region or locality, and which, therefore, in a statistical point of view, require to be included under a separate head. These ships were seventy-three in number, and consisted of ships of the line, frigates, and smaller vessels. Their mean force was about 10,000 men. The total number of deaths was 105, or in the ratio of 10-5 to 1000 of mean force. Of these 78 were from disease, and 27 from accident, the former being in the ratio of 7·8, and the latter of 2.7 per 1000 of mean force. The daily average of men ineffective from wounds and sickness was, for ships of the line, 395; for frigates, 45-8; and for smaller vessels, 40-2.. The total number invalided was 136.

There are, of course, fewer data for general sanitary, observations among so scattered a force, than in the case of squadrons employed in particular regions and services; nor do we here find anything relating to the prevalent diseases which need detain us....

Total Force.-There is a concluding section thus headed, some of the information contained in which we have anticipated in our notice of particular stations. The total mortality from disease in the navy for the year 1856 amounted to 629, or 71 per cent.; that from accidental

injuries, wounds received in action, drowning, and suicide, was 172, or 21 per cent.

The most fatal disease was fever, from which there were 199 deaths, or nearly 25 per cent. of the total mortality: of these deaths 130 were from yellow fever, of which 105 occurred in five small vessels-thus showing how the introduction of a fatal disease into a few vessels, not containing a fiftieth part of the force, may influence the death-rate in the naval service. Next to fever, consumptive diseases were most destructive to life, having been in the ratio of 27 per 1000 of mean force. The deaths from all diseases of the respiratory organs were 175, forming 21-9 per cent. of the total mortality. The deaths from disease of the heart and blood-vessels were 4.9 per cent., and those from diseases of the alimentary canal, 13-4 per cent. Of 64 deaths from dysentery, 48 occurred in the vessels employed on the coast of China. The total number of men invalided in the navy was 998, or 19.3 per 1000 of mean force.

The mortality from all causes, namely, 15.5 per 1000 of mean force, compared with the mortality in civil life in England, appears high; but, to make a just comparison, we must strike off at least two-thirds of the accidental deaths in the navy, as well as the deaths from yellow fever, which would reduce the total mortality in the service to about 10 per 1000 annually showing that the real mortality in the navy from all ordinary causes, is about the same as in the more healthy com. munities of men living on shore.

{ ,',

The aggregate loss of service from wounds and sickness in the entire navy was in the ratio of 61-7 per 1000, which exceeds the loss in the metropolitan and city police by a little more than one-third. These, it is assumed, are the only bodies of men beside the navy in which this mode of estimating the extent of sickness has been adopted. When we consider that a large proportion of the naval force is employed within the tropics, in regions highly detrimental to European constitutions, and that the police have much better means than the sailors of guarding against the evils arising from exposure to weather, by drying their wet clothing, and refreshing themselves with warm food and drink, the difference in the ratio of sickness is less than might have been expected. Add to this, that, in the police force, a shilling a day is stopped out of each man's pay as long as he is unfit for duty from illhealth, so that it is the interest of every man to keep off the sick list as long as he can; whereas, in the navy, there is no such regulation, so that indolent men and malingerers remain on it as long as they can impose on the medical officers. The majority of the police also are married men, so that they may be supposed to be less liable to contract venereal diseases than the seamen and marines of the navy. "On the whole, this is a very able and satisfactory Report, defective in very few particulars of any importance, though it is, perhaps, written in a more diffuse and less logical style than might have been desired in a document of this description. Here and there we meet with an ambiguity of expression which renders the exact meaning a little obscure; but this occurs chiefly with respect to minor details, and may

arise from ambiguities in the returns from which the Report is drawn up: in such cases it is certainly better to leave the meaning a little indefinite, than to determine it too precisely in a direction which may happen to be the wrong one.

REVIEW III.

Mémoires de Académie Impériale de Médecine.

Tome XXI. pp.

ccxlvi. et 600; Tome XXII. pp. cl. et 542. 4to. Paris, 1857-58.

THE two volumes of the Mémoires' we have here to notice do not contain any papers of commanding interest; but there are some the contents of which may be usefully made known to our readers.

I. The Pathological Anatomy of Cysts. By L. BAUCHET.-After passing in review the different classifications of cysts that have been proposed, M. Bauchet prefers that one derived from the nature of the matters or substances which constitute the contents of these bodies. It allows of the establishment of clear and precise divisions of the subject; while the nature of its contents being known, the structure of the cyst itself can almost always be predicated. In this way he constitutes ten varieties of cysts: 1. synovial; 2. serous; 3. mucous; 4. sebaceous; 5. milky; 6. hæmatic; 7. purulent; 8. parasitic; 9. foetal; and 10. pilous cysts. Of some of these subdivisions are made. Of course we have not space to go through the catalogue, and will confine ourselves to what the author states respecting synovial cysts. These he subdivides into articular, tendinous, and submuscular.

7

1. Articular Synovial Cysts.-These, again, constitute three varieties, accordingly as they are formed at the expense of the synovial membrane, outside of this, or by the synoviparous follicles. The first of these varieties is the only one that has been described even in our most recent works. A fold of synovial membrane protrudes through an aperture in the protective fibrous covering, and its communication with the synovial cavity is obliterated, a pedicle only remaining. The second variety, the author does not admit as of independent origin, but be lieves it originally constituted a hernia of the synovial membrane as above described. The third variety is the most interesting and curious, the true nature of its origin having been first established by M. Gosselin. There exist in joints culs-de-sac or follicles in a greater or less number, to which he gave the name of synoviparous follicles. By the examination of numerous joints, and especially the carpal, we are able to trace the evolution of this form of synovial cysts. Just as with regard to the sebaceous or mucous follicles, we may observe the membrane thrown into relief by little transparent elevations, varying in size from a pin's head to a pea or nut, and having at some part of their parietes a little black point, which cannot be better compared than to the lachrymal point. These are synoviparous follicles having their ducts obstructed and more or less filled with thickened synovia. The little cyst increases more or less in size, according to the region it is