within the can which may cause the buttery particles to Anatomical Examination terminated on Saturday. Fiftyseparate. Water Companies. MR. SIMON, in his new report, makes a suggestion which, while it may enlist the sympathies of some, will not fail to astound, and even shock, others. He would make public companies pay heavy damages to any one they may have injured. He sees, in fact, what all know as a familiar axiom on jurisprudence—that a wrong proved, a remedy lies; but he says "years may elapse before any aggrieved person, unless unusually rich and public-spirited, will be willing to incur considerable legal costs in testing his so doubtful claim to redress." dispute. Every one knows—at least every one whose reading has not been confined to journals that have so scandalously burked the truth—that there are plenty of authorities who regard the hypothesis in question as an unjustifiable assumption. Now, suppose for a moment Mr. Simon's views to be in full operation: the first point for a complainant to prove would be that the water in question was the sole cause of the case of cholera by which he suffered. We venture to say that no such proof satisfactory to a court of justice could be produced, and that in this case, therefore, Mr. Simon's remedy would not be practicable. That companies guilty of malfaisance are responsible to law, railway companies have found to their cost; but then, the injury has been easily proved. four candidates presented themselves, out of whom it was WE have been requested to announce that Mr. Grimshaw, We have no doubt that this announcement will be re ceived with regret by the members of our profession, whose working ranks Mr. Grimshaw has so long and so honourably adorned, and we believe all will honestly join in wishing Mr. Grimshaw a long enjoyment of his well-earned leisure. social ceremonial of dining is the ice-pudding? the luxuries of the diner a la Russe to learn that no ice pudding can claim to have achieved the loftiest degree of kindly instructed by recent authors, the paradise of gluttons appears to be losing its attractions. Between "Pure Leicestershire catsup," prepared from In the case of the water companies, everything rests on hypothesis, and men equal to, and even superior to, the putrid livers; ice puddings from decomposed fruit; pastry advisers of the Privy Council have asserted that the hy-nameless horrors in which the dining public has been so from the scrapings of filthy butter firkins, and all the pothesis is inconsistent with the facts. They would be as ready to dissent from, as Mr. Simon is to subscribe to, the assumption. What, then, could a jury do? By all means let us keep a tight rein on companies, and for knowingly distributing poisonous water let us hold every director and every servant concerned responsible. But let us not leave facts, and try to legislate on hypotheses. Sickness in Dublin. (Qui fit mæcenas?)—Who made Oscar Clayton, M.D., Surgeon-in-Ordinary to his Royal Highness the Duke of Edinburgh last week, and Extra Surgeon-in-Ordinary to his Royal Highness the Heir-apparent, before the second ringing of the Church bell? Who is the lucky rat that eats the malt that lies in the house that Jack built? Can their Royal Highnesses be supposed to be jointly moved by a sudden and irrepressible inspiration to place their lives and the succession to the throne of England in the hollow of Dr. Clayton's hand, or is our editorial vision so purblind, and our ear so deaf that we have all these years been insensible to the brilliant sunburst and the immortal fame of Dr. Clayton's genius? In abject and penitent submission we await the admission of the light, and in helpless obscurity we still puzzle over our enigma. Oscar Clayton, M.D., of a foreign university, Fellow (not by examination) of the Royal College of Surgeons of London, a worthy apotheTHE Quarterly Examinations at the Royal College of Sur-cary and general practitioner, does not seem to us the only geons in Ireland commenced last week, and the first half or eligible occupant of the pinnacle of court favour. Who is THE week ending the 8th instant has been an unhealthy one in Dublin, and as might have been anticipated, the great heat of the weather has produced its inevitable effect on the public health. The deaths numbered 144, or 25 more than the corresponding weeks of the last four years. The whole of this excessive mortality is chargeable to diarrhoea, which not only exceeded in frequency the preceding week as 32 to 18 cases, but that of the corresponding week of last year by 26. Two of the cases are registered as cholera, but we presume the real Asiatic type of the disease was wanting. it that keeps the second latch-key of the back-stairs wicket the bladder became urgent. State the nature of the injury; of Marlborough House? THE Registrar-General's returns are still unsatisfactory, although London exhibits a more favourable condition. Some towns show a largely increased mortality. Leeds gives the highest death-rate-41-2 per 1000. Bristol is at the top of the list. The 11 large towns rank as follows as to rates:-Bristol 240, London 25'8, Newcastle 26.2, Bradford 335, Liverpool 347, Sheffield 35.7, Birmingham 37.5, Hull 38:3, Salford 387, Manchester 40'3, Leeds 41.2. It would thus appear that London is likely to soon again show the favourable return on which we have so often commented. A fortnight ago the deaths in the metropolis were 1885; the mortality then declined to 1665, and has now fallen to 1545. This is only 52 higher than the average for the last 10 years, corrected for the increase of population. Zymotic diseases were fatal in 593 cases, the average being 571. The deaths from diarrhoea were 294, against 384 the previous week; 270 out of the 294 were the cases of infants. The highest day temperature at Greenwich was 90'5; lowest night temperature 52.8. Rain only fell once, and then only to the extent of 0.14 of an inch. 2. Describe the urinary bladder, and its relations to the immediately surrounding parts; the differences of relation it presents in various degrees of fulness, and at different periods of life; the arrangement of its muscular fibres, and the character of the epithelium by which it is lined. 3. Describe the structure of the spinal chord (below the medulla oblongata); and state what has been determined experimentally with regard to the transmission of sensory and motor impressions through it. 4. Describe the prostate, its relations and structure. 5. Mention the varieties in the origin and course of the blood vessels, to be regarded in the operations of laryngotomy and tracheotomy. 6. State the peculiarities of the blood in the hepatic, renal, and pulmonary veins, respectively. SURGERY. Monday, August 10th, 1868, 2 to 5 p.m. 1. What would be the immediate symptoms, physical and general, in a case, in which fracture of three or four ribs, with laceration of the lung, had occurred on the right side, and what would be the changes observed in the symptoms, under a favourable progress? Describe the treatment to be adopted throughout. 2. A man was wounded by a rifle bullet, which entered at the anterior margin of the deltoid muscle, and passed out behind the shoulder; in its course it comminuted the head, as well as an inch and a-half of the upper extremity of the humerus. State what treatment should be pursued in such a case, and what would be the probable result. : 3. A boy, in attempting to walk on the top bar of a railfence, slipped, and fell across it, striking the perinæum shortly after, much swelling and discolouration of the part was observed; nor could urine be passed when the desire to empty the treatment to be adopted; and what usually, is the ultimate result of such an accident. 4. Describe the symptoms, and course of a case of scrofulous disease of the upper cervical vertebræ (1st to 4th). At what period of life does it usually occur and what are the pathological changes observed after death? 5. Describe the symptoms of stone in the bladder. What are its pathological effects on the bladder and kidneys, if not removed? Under what conditions should the operation of lithotomy, or lithotrity, be preferred? 6. Describe the symptoms, and results of syphilitic iritis, if neglected. What treatment should be pursued to arrest its progress? MEDICINE. Tuesday, August 11th, 1868, 10 a.m. to 1 p.m. 1. Give an account of the Malarious Fevers, including the presumed causes, the symptoms, and the treatment. 2. Give the stethoscopic signs of the following diseases: pneumonia; pleurisy, with effusion; hydro-thorax; pulmon ary apoplexy; coincident constriction and patency of the cardiac mitral opening and similar conditious of the aortic orifice. 3. What do you mean by the terms anæmia, chlorosis, and leucocythæmia? Describe carefully the state of the blood; the condition of the various organs, and give the treatment in each case. 4. Mention the chief conditions of the urine whish are important for diagnosis, and describe a case of Acute Morbus Brightii in an adult man. 5. For what purposes are conium, belladonna, and henbane used in medicine? Mention the chief pharmacopoeil prepar tions, and state what is known about the action of the active principles. 6. What are the chief diseases which may come on in the first week after confinement? Give the chief symptoms, and, briefly, the treatment. NATURAL HISTORY AND PHYSICS. I. ZOOLOGY. 1. Enumerate the principal varieties of the human race, and state their distinctive characteristics and geographical distribu tion. 2. Describe the principal modifications in the form and ar rangement of the placenta, and state how far its various forms are useful in classification. 3. Give the characters of the class colenterata; mention its primary divisions, and name a genus belonging to each. 4. What is meant by spontaneous generation? Give some account of the experiments which have been made to prove or disprove it, and of the arguments that have been used for and against it. 5. Give an account of the geographical distribution of some of the larger divisions of the mammalia. II. BOTANY. 1. Give an account of the process of impregnation in phe Clonmel, county Tipperary, Lic. 1868, and Lic. Midwifery, 1868, K. Q. Coll. Phys. Irel., Lic. R. Coll. Surg. Irel., 1868; David John Forbes, 4, Grande Parade, Cork, MD., Queen's Univ. Irel., 1867; Robert Henry Robinson, Parson-town, King's county, Lic. 1867, and Lic. Midwifery, 1867, K. Q. Coll. Phys. Irel., Lic. R. Coll. Surg. Irel., 1867; James Maybury Beamish, Lahara House, Drimolegue, county Cork, Collins, 25, Harcourt-street, Dublin, M.B. Univ. Dublin, 1865, Lic. M.D., 1868, and Master-Surg., 1868, Qu. Univ. Irel.; Edward Wolfenden 1868, and Lic. Midwifery, 1888, K. Q. Coll. Phys. Irel., Lic. R. Coll. Surg. Irel, 1868; Henry Stannard, 18, Shelbourne-road, Beggar's Bush, county Dublin, Lic. R. Coll. Surg. Irel., 1867, Lic. 1868, and Lie. Midwifery, 1868, K. Q. Coll. Phys. Ir 1.; John William Moore, 40, Fitzwilliam-square, West, Dublin, M.B, 1868, and Master-Surg., 1868, Univ. Dublin; Francis Richard O'Grady, Churchfield, Ballyhannis, county Mayo, Lie. R. Coll. Surg. Irel., 1867, Lic. K. Q. Coll. Phys. Irel., 1868, Charles William Shaw, Castle Blayney, county Monaghan, Lic. R. Coll. Surg. Edin., 1868; Robert Little, jun., Combermere Lodge, Lifford, county Donegal, Lic. R. Coll. Surg. Irel., 1868; Patrick Lynch Walsh, Kilfinane, county Limerick, M.D., 1868, and MasterSurg., 1868, Qu. Univ. Irel., Lic. Midwifery, K. Q. Coll. Phys. Irel., 1868; William MacDonnell, Broadford, county Clare, Lic. R. Coll, 9, Harrymount, Kingstown, county Dublin, M.B., 1868, and MasterSurg., 1858, Univ. Dublin. REPRESENTATION IN THE MEDICAL COUNCIL. Phys. Edin., 188, Lic. R. Coll. Surg. Edin. 1868; James Francis Ryan, TO THE EDITOR OF THE MEDICAL PRESS AND CIRCULAR. SIB,-Much confusion prevails about the Cambridge University. Dr. Ashe is not altogether right. He seems to regard the Senate and the large constituency as two distinct bodies. They are in reality one. The Senate is the elective body, and consists of all M.A.'s and all doctors who have kept their names on the books. The number exceeds 5400, as stated by our able representative in the Council, Dr. Paget. All these may vote at the election of Dr. Paget, and, therefore, our University is one of the most liberal bodies. If the other Corporations did as much the plan of indirect representation would be carried. The advocate of this plan would do well to revise his scheme so far as Cambridge is concerned. The election by the Senate at Cambridge is really a fair illustration of the popular election for which Dr. Prosser James is contending in the Medical Corporations, and which exists in some degree in the College of Physicians. There is no intermediate smaller body to control the election at Cambridge, as Dr. Ashe supposes. The original constitution of the ancient Universities was very popular, and much of the popular spirit survives in the customs and regulations of Cambridge, and, I believe, of Oxford also. Almost nothing can be done without the consent of the whole body of the Senate. These points are worthy the attention of Medical Reformers.-I am, &c., A MEMBER OF THE SENATE OF THE UNIVERSITY "FISTULA IN ANO." TO THE EDITOR OF THE MEDICAL PRESS AND CIRCULAR. SIR,-Having lately seen several operations for fistula, and also having remarked the great difficulty the surgeon experiences in keeping the buttocks separate, the idea struck me that the operator might be greatly assisted by having a broad piece of adhesive plaster attached to each buttock as far up towards the anus as possible. When these are firmly attached, an assistant at each side of the patient making extension with ends of the plaster will, I think, effectually keep the buttocks If some separate, and thus facilitate the operation greatly. of the numerous readers of your valuable journal would make a trial of this suggestion, they would greatly oblige, yours obediently, A MEDICAL STUDENT (Dublin). LIST of Entries in the Register of the Branch Medical Council (Ireland), for the month of July, 1868 : James Dunlop, Edenderry House, Lisburn, county Antrim, Lic. R. Coll. Phys. Edin., 1867, Lic. R. Coll. Surg. Edin., 1867, M.D. Qu. Univ. Irel., 1868; William Henry Goode, Finglas House, county Dublin, M.B., 1867, and Master-Surg, 1867, Univ. Dublin; James Chatterton, Ballynamote, Cork, M.D., 188, and Master-Surg., 1868, Qu. Univ. Irel.; James Crawford, Templeton, Killashee, co. Longford, Lic., 1868, and Lic. Midwifery, 1868, K. Q. Coll. Phys. Irel.. Lic R. Coll. Surg, Irel., 1868; Richard Dawson Bennett, Union Hall, Leep, county Cork, Lic. R. Coll. Surg. Irel., 1868, Lic. Apoth. Hall, Dublin, 1868; Patrick Thomas Lyster, King-street, Athlone, Lic., 1866, and Lic. Midwifery, 1866, K. Q. Coll. Phys. Irel., Lic. R. Coll. Surg. Irel., 1866; Frederick Fitzgibbon, Castle Selem, Ro-scarberry, county Cork, Lic. R. Coll. Surg. Irel., 1867, Lic. 1867, and Lic. Midwifery, 1867, K. Q. Coll. Phys. Irel.; Patrick Murphy, Mitchelstown, county Cork, M.D., Qu. Univ. Irel., 1868; Charles Gore Purcell, Tramore, county Waterford, M.D., 1867, and Master-Surg., 1867, Qu. Univ. Irel.; William Henry Saunderson, Edender y, King's county, M.D., 1-68, and Master-Surg., 1868, Queen's Univ. Irel., Lic. Midwifery, K.Q.C.P.I.; John Joseph Crean, Glenview, MILITARY HOSPITAL ARRANGEMENTS IN PRUSSIA.Professor Esmarch, of Kiel, has substituted the ordinary shirting triangle for the bandage which Prussians soldiers used to carry in their knapsacks. He has managed the triangle in such a way that the first dressing of wounds and fractures can, behind the firing line, be instantly applied, guns and bayonets being used as temporary splints. M. Wittmaack has sent to the exhibition of Kiel an oil painting representing an action, and the manner in which the triangle should be used. The picture has attracted much attention, and it has been ordered to be printed on each of the triangles given to the troops, so that they may, on the very linen used, see the manner of employing it. EARLY PREGNANCY.-Dr. Horwitz was called to a pregnant girl who had scarcely reached her 12th year, and of whose age there could be no doubt. The menses first appeared during her 10th year and continued regularly. She went through her pregnancy very comfortably. The pelvis was well formed and capacious. The labour proceeded very favourably, and terminated in ten hours with the birth of a strong living male child. She went on very well, and had a plentiful secretion of milk. References are given to other remarkable cases of the kind on record.-Petersburg Med. Zeitschrift, 1867, No. 9. HOW TO UTILIZE LEECHES.-The German doctors have lately been playing their leeches a droll trick-making one worm do the work of many. When the little blood-sucker has taken his fill and is about to release his bite, he is tapped; a small incision is made in his side, that serves as an outlet for the blood, and he goes on sucking, in happy ignorance of the cause of his abnormal appetite, as long as the doctor pleases. Bdellatomy is the name given to the practice, and it is urged that it is not cruel, but contrary wise, since it does the leech a good turn by enabling him to enjoy his rich feast indefinitely He does not die under the operation, but with proper treatment is soon healed, and may be incised over and over again. There was once an alderman who wished he had been a camel, that he might have been blessed with the seven stomachs vouchsafed by nature to that animal. If such a gourmand still exists, let him seek surgical aid in some such treatment as that practised on the leeches, that he may eat and drink ad libitum, and feel no worse.-Once a Week. VITAL STATISTICS OF THE NAVY.-The statistical report of the health of the Navy just issued gives a very favourable view of the sanitary condition of the force afloat in 1865. The total force was 51,210 men; the cases on the sick list numbered 69,315, which is in the proportion of 1368 per 1000 of mean force, being slightly below the ratio of the previous year. The total number invalided was 1687, or 329 per 1000, a reduction, as compared with the previous year, of 25 per 1000. Of those invalided 181 were for wounds and injuries. There were 580 deaths, 416 being the result of disease, and 164 of wounds, injuries, and drowning. The total death-rate was 11.3 per 1000 of mean force, which is a reduction, as compared with the preceding year of 27 per 1000. The mortality from disease alone was 81 per 1000. The lowest sick-rate was on the Mediterranean station, 334, and the highest on the China station, 80 4. On the west coast of Africa yellow fever was epidemic, and in China small-pox prevailed in the squadron at Japan. At the former station, fever increased the mortality to the extent of 28.4 per 1000. Cholera appeared in the Mediterranean, and occasioned great mortality among the civil and military population of Malta. The loss annually sustained by the navy from small-pox has caused Dr. Mackay to suggest the propriety of considering whether it may not be advisable to introduce a system of periodical revaccination into the service. The death-rate on the home station from disease was 5.8 per 1000, and from violence 1.3; on the Mediterranean station, from disease 6:2, from violence 2; North America and the West Indies, from disease 7.7, from violence 48; South-east cost of America, from disease 7.6, from violence 38; Pacific, from disease 3.8, from violence 3.4; West Coast of Africa, from disease 38.2, from violence 10; Cape of Good Hope and East Indies, from disease 94, from violence 55; China, from disease 177, from violence 5.5; Australia, from disease 44, from violence 62; and in the Irregular force, from disease 2.5, from violence 4.4. DISEASE CAUSED BY HEAT IN AMERICA.-The number of persons reported as having been prostrated by the heat during the past 24 hours in this city, Brooklyn, and Jersey city exceeds 100. Over 50 per cent. of these have proved fatal. Dr. Harris, Registrar of Vital Statistics of the Board of Health, makes the startling announcement that 250 deaths are known to have resulted from the excessive heat of the past three days within the metropolitan district. The highest range of the thermometer in this city yesterday was 94. In Pough keepsie it was 103, in Baltimore 102, in Montreal 105, and in Richmond, Virginia, 96. In a note addressed to the President of the Metropolitan Board of Health, on Wednesday afternoon, Dr. Harris, the Registrar and Corresponding Secretary of the Board, suggests the following brief precautions against sunstroke:-1. When exposed to excessive heat the natural perspiration or sweating must not be checked. Let the sweat How, and do not throw off all the flannel garments. 2. Wash the head and neck frequently in cold water, and, if exposed in the sun, or in any very hot place, wear upon the top of the head, under a hat or otherwise, a light handkerchief or other thin folds of cloth wet with cold water. Remember that the head and neck must he kept cool, and also be free from the pressure of tight clothing. 3. If headache, dizziness, a feeling of tightness across the forehead, a failing of sight, or a feeling of weakness and prostration ('giving out') occurs, let the person immediately go to a cool place and lie down, with the back and the feet covered, and have a few quarts of cold water poured slowly upon the head and the sides of the neck. If the symptoms are not at once relieved send for the nearest good physician. 4. What to do until the physician comes.-If the patient is still sweating let him drink freely of cold black tea or coffee; tea is best. But if sweating has ceased there is very great danger. Then the head, face, neck, and entire chest should be rapidly sponged with ice-water, and a bag of powdered ice, well covered with a towel, should be kept under the head and the back of the neck; give a mixture of the carbonate of ammonia (hartshorn) and muriate of ammonia, eight until the physician comes or until the patient rallies and or ten grains of each in water, every ten or fifteen minutes sweats. Enfeebled, intemperate, poorly-fed, over-fed, and irritable persons, are most in danger of the fatal effect of heat. People who live and sleep in foul air and unventilated places, and who are overworked and underfed, and who use intoxicating drink, suffer greatly. Instead of intoxicating drink and the habit of morning and evening drams, let good black tea and coffee, and good, nourishing, and well-cooked food be regularly taken. Bathe the whole body early in the morning in order to have a clean skin and good natural sweating during the day. Labourers and others who have much to do should rise so early that they can have several rests and keep in the shade from eleven till four in these very hot days; and let this most important fact be remembered--namely, that by natural sweating (perspiration) the body is kept healthfully cool when exposed to these terrible heats, and that over-exertion, passion, and all kinds of intemperance must be avoided. In his note to the President of the Board of Health, Dr. Harris justly urges that the contractors, builders, and other great employers of labour should be urged to be considerate to their men, and give them the advice and the opportunity for rest which they now need. The fact that the first fifteen days of July have had an average or mean temperature ten degrees higher than has been experienced in more than 25 years shoul lead all our fellow-citizens to use every means possible to encourage or enforce sanitary cleansing and the observance of the rules of health. Especially should these suggestions concerning sun. stroke be heeded.”—New York Herald. BRITISH ASSOCIATION AT NORWICH.-It has been for some time past generally known that an unusual influx of foreign savants is expected at Norwich this week. The follow ing are some of the names most intimately connected with our own profession :-Dr. Carl Vogt and Dr. Appia, from Geneva; Professors Béhier and Broca, from Paris; Drs. Laage, Boorgaard, and Heinsius, of Leyden; Professor Favre, of Lyons; Professor Sartorius Walterhausen, of Halle; Professor Nilsson, of Sweden, etc., etc. Several of these distinguished professors have important communications to make, and will take an ac tive part in the proceedings of this, the thirty-eighth annual meeting, which promises to be one of the most brilliant in the annals of the association. The first general meeting will be held on the 19th inst., at 8 P.M., when his Grace the Duke of Buc. cleuch will resign the chair, and Dr. Hooker, F.R.S., will assume the presidency and deliver an address. The Interna tional Prehistoric Society will also hold its meetings at Norwich during the week. to. THE amount of work which will here pass muster for a fair day's toil is far beyond what is expected of a man in Great Britain. This is no country for foreign idlers to come are willing to pay Englishmen, Irishmen, Germans, or any The Americans hate physical exertion themselves, and body else to come here and do the hard work for them, but they will take great care to get as much out of the people they pay as can be either wheedled or forced from their bones. I have been very much struck here by the fact of the evident dislike of hard work which animates the real American. If I have noticed a man in a workshop or in the open air driving at his work with a will and an apparent relish, as is so commonly seen in England, I have said to myself, that man's grandfather was not an American citizen; and upon inquiry I have seldom found that I was mistaken. The dry climate may have something to do with it, for I have observed elsewhere that dry climates do not seem conducive to an appetite for manual labour, but they seem to make people more nervously ing-man's Letter in Daily News. active than the denizens of a damper region.-English Work THE Army and Nary Gazette states that at the Curragh instructions have been received that, as a sanitary measure, patients in military hospitals are to be allotted 1200 eubic feet of space each, and arrangements are being made to give effect to these instructions as soon as possible. "SALUS POPULI SUPREMA LEX.” WEDNESDAY, AUGUST 26, 1868. CONTENTS. LECTURE. Is the Administration of Wine in Acute On the Nature of the Phenomena of 179 Phelan on Puerperal Fever in Lying-in Hospitals... 193 180 182 Lecture. LEADING ARTICLE. IS THE ADMINISTRATION OF WINE IN ACUTE DISEASE A MERE FASHION? BY THOMAS WRIGLEY GRIMSHAW, M.D.DUB., LECTURER ON MATERIA MEDICA IN DR. STEEVENS' HOSPITAL, AND ONE OF THE PHYSICIANS OF CORK-STREET FEVER HOSPITAL. (Abstract of one of a Course of Lectures on Materia Medica and Therapeutics delivered in Dr. Steevens' Hospital during the Summer Session of 1868.) GENTLEMEN-In yesterday's lecture I detailed the varieties of wine and fluids containing alcohol, classifying these fluids into weak wines and beers, strong wines, and ardent spirits. I pointed out to you that weak wines have peculiar tonic, and invigorating properties, independent of the slight stimulating powers which they possess, owing to their contained alcohol. I informed you that the stronger wines possess these properties, and that they also possess in a considerable degree the powerful stimulating and antiseptic properties of alcohol. I shall now proceed to direct your attention more particularly to the physiological and therapeutic effects of alcohol, or rather of fluids containing alcohol in sufficient quantity to give a special character to their action, and entitle them to the popular term of alcoholic fluids. The great characters of an alcoholic fluid are stimulant and antiseptic, and if given in excessive doses narcotic. The combination of stimulant and narcotic properties in the same agent is not new to you, as I have already in past lectures remarked on such a combination, especially in the case of opium. Alcoholic fluids, however, are seldom employed therapeutically as narcotics, but frequently as stimulants; whereas opium is nearly always employed as a narcotic, and seldom as a stimulant. You therefore in your classifications of remedies usually find opium in the list of narcotics, and alcoholic fluids in the list of stimulants. It is chiefly as a stimulant we have to deal with alcohol in these lectures, although I shall also have a few words of commendation to say of its antiseptic, and a few of caution to give, with regard to its narcotic properties. These considerations of the properties of alcoholic fluids, as well as when, where, and how they are to be made available in therapeutics, I shall leave for consideration in a future lecture, and I only ask you at present to take it for granted, that alcoholic fluids are stimulants (not of course denying that they are also narcotics). The Abergele Catastrophe.................... Gleanings and Medical News..... As alcoholic fluids are our main-stays as stimulants, and are in much more common therapeutic use at the present than at former times, I shall point out how it happens that they have come to occupy so important a place in our materia medica, as compared with that of our predecessors. The slight use made of alcoholic stimulants by the physicians of past ages must have depended upon, either the medical opinion of the day, or upon the kind of diseases then prevalent. If upon the latter, either diseases of former times differed from those we now meet with, or we are altogether wrong in our extensive use of stimulants; but we are not wrong (as, for the sake of argument, I shall now assume, leaving the proof to the next lecture), therefore diseases differ from those of former days, or medical opinions differ; and, assuming we are right in our opinions, the physicians of former days, from Hippocrates to Sydenhamn, and from Sydenham to our own times, must have been ignorant of the treatment of many of those diseases which they professed to know how best to cure; not only ignorant, but so grossly ignorant, that in many cases they pursued treatment which we know must have been absolutely injurious, and even dangerous. Can we possibly believe that such ignorance existed among those who have been first in the improvement of medical science; who, with small means at their disposal, were accurate observers of disease; and who, without chemical tests, stethoscopes, ophthalmoscopes, laryngoscopes, endoscopes, thermometers, or sphygmographs, clearly described symptoms and made accurate diagnoses-frequently as accurate as our own with all these aids of physical science? The answer is that these great men were not ignorant, and that they themselves have given proof of their knowledge in their works, which have come down to us. Not only have they proved their knowledge of, and ability to treat disease, but they have left sufficient evidence, that if they had had the same kind of disease to deal with in their day, as we have in ours, they would have followed pretty much the same principles as we do, and that in the administration of stimulants they did follow these principles. Although wine was not their commonest stimulant, yet they frequently used it, alone or in combination with other agents, or artificial cordials composed of many stimulants, sometimes including wine or spirits of wine. The question of the use of stimulants by our predecessors is necessarily mixed up with the consideration of the tise of agents of the contrary character, such as blood-letting, emetics, and other depressants. |