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thus giving rise to effusion of part of the contents. At itsgreat curvature, the stomach was adherent to the pancreas,and it still contained a pint or thereabouts of thick, dark-brown fluid. On removing and laying open this viscus, thegeneral surface of the mucous membrane was found to betolerably healthy, but slightly acted on in parts by the gastricjuice. In the neighbourhood of the ulcer, however, therewas considerable irregular thickening.

Acetic Acid in Typhus Fever.W. H. F. suggests that the strong acetic acid be exhibited

in the treatment of typhus fever, to the extent of three orfour drachms daily. He remarks that this disorder is princi-pally treated by ammonia in our fever hospitals, workhouses,and parish cases, and adds, " we are aware that ammonia isalways present in the atmosphere of the room, the urine,breath, &c., of the patient, and therefore it stands to reason,that if ammonia be evolved from the body which is putrefying,it must be entirely wrong to give it as medicine. Ammonia,"he says, " is the product of putrefaction and thereforehastens the decomposition and death of the patient. Aceticacid, on the contrary, will stay putrefaction; give ease to thepatient; and, if seconded by strengthening medicines, will, hehopes, effect a cure."** W. H. F. is reasoning as if the human body were a

mere chemical laboratory, forgetting altogether, that althoughChemical processes are carried on in it, yet they are, to agreater or less extent, modified by the influence of the prin-ciple of life. It does not follow, because ammonia is evolvedfrom the person of a victim to typhus fever, that thereforeits internal exhibition is injurious and contra-indicated. Ex-

perience proves the contrary. Probably W. H. F. will bekind enough to furnish us, in brief, with the results of hisexperiments with acetic acid, in the treatment of typhusfever.

MEDICAL POLITICS.

" JUSTITIA," in explanation of his views of a " legal autho-rity," (vide his previous letters,) says he takes it for grantedthat the appointments made by her Majesty’s officers wouldbe considered legal; the medical men in the army, navy,East India service, Poor-law Unions, &c., are not required topossess the licence of the Society of Apothecaries, while theypractice as apothecaries in every sense of the word. If, hesays, these are not legal acts, they certainly emanate fromthe highest legal authorities."

*,* " Justitia" is in error with regard to the Poor-lawUnions. No medical man can be a surgeon to any Union inEngland or Wales, unless he possess the licence of theApothecaries’ Company, or was in practice on or before the1st of August, 1815. The Act of the Company has no controlover the other medical officers to whom he alludes.

Reviews.

Report on the Climate and Principal Diseases of the AfricanStation; compiled from Documents in the Office of tlae Director-general of the Jfedical Department, and from otleer sources, incomplin-race with the directions of the Iliglat Horzaurable theLords Commissioners of the Admiralty. Under the immediate ’,direction of Sir William Burnett, M.D., K.C.H., F.R.S. ByALEXANDER BRYSON, M.D., Surgeon R.N. London: 1847.pp. 260.

Report en the Fever at Boa Vista. By Dr. M’WILLIAM. Pre-sented to the House of Commons, in pursuance of theirAddress of the 16th of March, 1847. London : 1847. pp.112.

Letter addressed by Sir William Pym to the Lords of the Council,relative to a Report on the Fever at Boa Vista, by Dr.M’WILLIAM. Presented to the House of Commons, in piir-suance of their Address of May 14th, 1847. London : 1847.pp. 15.

THE first work on our list was, it seems, prepared by theauthor, in consequence of a minute addressed by the Lords ofthe Admiralty to Sir William Burnett, physician-general ofthe navy, requesting him to cause to be embodied in a reportsuch portions of the medical returns from the African stationas might be deemed valuable,-the report to be prepared insuch a form as would present the greatest amount of informa-

tion " regarding the diseases contracted on that station, thelocalities most injurious to health, the precautions whichmight be taken to arrest or diminish fever, and the mode of £treatment regarded most effectual ; embracing also the dis.eases most prevalent amongst the captured slaves !" As thiswork has been printed by order of the Lords of the Admi.ralty, solely for the use of the medical officers employed onthe African station, it is, of necessity, inaccessible to themajority of the profession. We purpose, therefore, to makea somewhat lengthened esquisse of its valuable contents, iuorder that our readers may be better acquainted with thenature and treatment of a most formidable malady-a know-ledge of which must be of value to them, although it is not

likely that many of them will be called upon to treat

patients labouring under it. Still not a few may derivedirect benefit from being made acquainted with the contentsof this work-at least, such as are engaged in the merchant-service, and employed on that inhospitable coast. From the

length of time during which many merchant vessels are

detained in the rivers on the African coast, where the diseaseis generally contracted, their crews are frequently invadedand decimated by this pestilence, nor have any means of pre-vention or of cure been hitherto brought forward, with suchevidence in its favour as to warrant the placing reliance onthem. Its nature and treatment have been alike unreco-

gnised ; the most violent remedies and the most gentle haveequally failed in effecting a cure; while, on the other hand,some patients have apparently recovered in spite of thedoctor. Under these circumstances, and urged to do so pro.bably by the late fearful epidemic on board the " Eclair," whichbrought the pestilence home to our own shores, the minutewas issued, requiring the preparation of an arranged abstractof such portions of the medical returns from the Africanstation, as bore on the nature and treatment of the remittentfever contracted on the coast and in the rivers of that quarterof the globe.

Dr. Bryson, the gentleman to whom the task was confidedby Sir W. Burnett, is singularly fitted for the performance ofthe task. His engagement in the ofice of the physician-general had previously prepared him for the duties of drawingout the Report in a tangible shape, and he was enabled to il-lustrate many important features of the disease, and also todiscriminate between the several plans of treatment recom-mended in the respective reports which came under his notice,from the extensive stores of his personal experience, ac.quired during a very extended servitude on the coast and inthe rivers of Africa. Dr. Bryson has, we may boldly say, pro-duced a work which will be of great service as a guide to hisprofessional brethren in their management of this intractabledisease, and which reflects great credit on his skill, industry,and professional knowledge.The work commences with a brief sketch of the topography

of the African station, extending from Cape Verde on thenorth, to Cape Negro on the south of the equator. We havehere an account of the Bissagos, Sierra Leone, the Bullomshore, Cape Mount, the Gold Coast, Accra, Quitta, Popoe,Whydah, Lagos, Princes’ Island, Fernando Po, St. Thomas,Anna Bona, Cape Lopez, Benguela, Loango, Kabenda,Ambriz, St. Paul de Loanda, Quicombo, Lobita, Equemma,the bights of Benin and Biafra, the rivers Gambia, Nunez,Pongos, Melacoorie, Scarcies, Sherbro, Gallinas, Volta, Benin,Nun, Brass, Bonny, Calebar, Cameroons, Gaboon, Camma,Congo, and Elephant, and Massamedes, or Little Fish Bays.The principal localities where disease is most frequently con-

tracted appear to consist of alluvial soil and extensive marshes,covered with mangroves. With respect to the settlement onthe Gambia, it is remarked, however, that

"Notwithstanding the vast alluvial swamps that bound nearlythree sides of this small settlement, it is, upon the whole, infi-nitely less detrimental to the European constitution than isSierra Leone. The temperature throughout the year is some-

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what lower, although this is chiefly observable during the Imornings of the winter months, when the air, until the sunhas risen a few degrees above the horizon, is frequently sosharp and bracing as to require additional clothing; but theheat of the day during summer is at all times exceedinglyoppressive, and is rendered doubly so by the reflection of thesun’s rays from the loose white sand in the streets and uponthe beach. Remittent fevers occur throughout the wholeyear; but from November to April they are by no means ofa formidable character, unless contracted under peculiarlyaggravating circumstances, such as an intemperate course ofliving, with exposure and fatigue in the marshes, or fromsleeping in the open air during the night." From July to October the nature of the place is totally

changed, and no vessel, during that period, can remain morethan a week or two at a time at anchor near the settlement,with safety to the health of her crew. During the formermonths the rains commence, and continue to fall, with shortintervals of fine weather, until September, when the river,having become enormously swollen, and of a tawny colourfrom the admixture of soil, overflows its banks, and floods themarshy flats behind the settlement to a great distance,where, as the rains decline and the river withdraws into itsproper limits, it leaves large shallow lagoons to be evaporatedby the heat of the sun and the drier winds of the succeedingmonths.

" During this season, therefore, Europeans, whether on shoreor in vessels at anchor in the river, are apt to be assailed byremitting fever of a more virulent character than during thedry season, while the more acclimated residents suffer fromintermittents generally of an irregular type. Both theseforms of disease, it has been assumed, are the result of thesame catise-nainely, the increase of marsh eflluvia in theatmosphere, which, in some localities, is at times perceptibleenough to the sense of smell at a considerable distance fromthe source of its elimination."—pp. 4, 5.The character and danger of the rivers on the African coast

may be gathered from the following extract respecting theNunez and Pongos, in the Bissagos country."The rivers upon this section of the station requiring the most

constant attention of the cruisers, are, as previously observed,the Nunez and Pongos, both of which have occasionally beenentered by vessels of light draught of water, although, for thepurpose of more thoroughly searching them, boats are moreconvenient, and have been more frequently employed. Theirbanks, like those of all sluggish streams in this country, aredescribed as being closely fringed with mangrove bushes,around the tangled roots ot which there is a thick depositionof blue mud or slime, the detrital sediment of the river water,together with the rotting remains of branches, leaves, andother vegetable matters, swept down from the interior during I,the rains. These substances, it appears, accumulate in the Iestuaries of large rivers until, after being urged backwards andforwards by the tide, they at last become entangled amongthe mangrove bushes, or are thrown upon the shore in shallow,stagnant creeks, where they rapidly pass into a state of decay,mingled with other substances of a marine nature. Duringthe heat of the day, when the tide recedes and leaves thissemi-putrid mass exposed to the heat of the sun, the elimina-tion of foetid malaria, as may be supposed, is most abundant.It is also supposed to remain suspended in a more concen-trated, and even in a more dangerous, form in the dense fogswhich frequently overhang these morasses from sunset tosunrise. It cannot, therefore, be a matter of wonder that menarriving in these rivers from the clear atmosphere of the opensea, worn out and drenched in perspiration with long andheavy pulling, hungry, thirsty, and at last cold, should fall aneasy prey to the demon of the place-the indigenous pestilenceof the swamp. Although at times some may have escaped, ithas too often been but the exception to the rule, particularlyif to this catalogue of evils rain has been added, and this,during at least five months of the year, will too frequently bethe case."-pp. 6, 7.Dr. Bryson confirms the opinion generally entertained, that

a far greater proportional amount of disease is contracted atSierra Leone by the naval force, than upon any other part ofthe station; but he adds, that a great proportion of disease iscontracted in consequence of accidental or contingent circum-stances peculiar to the locality, from causes common to thewhole line of coast, rather than from an increase or an aggrava-tion in the condition of such causes in the locality itself; andof these none seem to operate more powerfully or more fre-

quently than exposure on shore to the intense heat of the sunby day, or to the chilling dews by night-more particularly ifaccompanied in either case by a state of inebriation, or ex-haustion of the physical powers of the body from over-exer-tion. The facilities for getting intoxicated at Sierra Leoneappear to be as numerous as in any of our seaports, and sailorson the coast seem to be as eager after that kind of enjoymentas in England. The consequence of intoxication and a nighton shore, either in a low public-house, a native’s hut. or onthe bush, is almost invariably an attack of fever. But thedanger seems most to affect the officers and men composingprize-crews. These generally arrive worn out by excessivelabour, broken rest, and exposure by night and day upon thedeck of a small vessel, probably crowded with slaves, and in aloathsome state of misery and disease; and the men, being,after landing, free from control, to a certain extent, plungeinto every kind of excess. Few entirely escape the conse-quences, and many are seized with fever, while still at SierraLeone. Refitting ship is regarded as another cause of feverat Sierra, on account of the ease with which men, while soemployed, smuggle spirits on board, and give way to intoxica-tion. Still Sierra has its advantages as a place of refuge forthe squadron for watering and victualling. The supply ofvegetables and fruit is very extensive, and the water is saidto be excellent.The essential causes of fever appear to be as difficult of

discovery as ever. The nearest part of the Bullom shore toFreetown is five or six miles; and although it has the appear-ance, when viewed from the harbour, of being one continuousdensely-wooded swamp, such is not the case. The woods are

open behind the thicket on the bank of the river; and nearMedina, on the west, there are many tracts of land undercultivation; the village itself is considerably above the levelof the river. To the southward and eastward, also, thecountry is not swampy. The town itself is built on the baseand side of a rocky hill, completely denuded of bush, andincapable, at any time of the year, of retaining much moisture;and a large portion of the land in its vicinity is under culti-vation.The rivers Sherbro and Gallinas are similar in appearance

to the Nunez and Pongos, and equally prejudicial to health.On the banks of the Gallinas, there is one of the mostnotorious slave marts on the coast. There are not any of theextensive swampy deltas or sluggish streams, with stagnant,shallow creeks and mangrove-covered shores, at Cape Coast;and the rocks are mostly of primitive formation. AroundAccra there is an extensive open prairie for many miles, whichis covered with tall, strong grass, presenting a parched,blighted appearance in the dry season, and a rank and vigorousvegetation in the wet. The European residents suffer gene-rally from endemic fever, and afterwards, from irregularparoxysms of intermittent. The territory of the Volta

appears to be a vast alluvial plain, a branch of the riverforming an extensive lagoon." From Quitta to Popoe, and from the latter to Whydah,

the shore has the appearance of a low sandy ridge; behindthis, and at no great distance from the sea, there is another ofthose extensive sheets of water, half river and half lagoon, sopeculiar to this part of Africa Its waters are of a darkmuddy colour, and brackish, and glide along amongst thickreeds and grass with an almost imperceptible motion, depo-siting upon its banks and bottom a black ooze, which emits,when disturbed, a most offensive odour. It extends upwardsto the basin of the Volta behind Quitta, and laterally expandsinto smaller shallow lagoons, the shores and islands of whichpresent the same character, and are densely covered withjungle, stunted palms, or flags from four to six feet in height,which occasionally encroach so far upon the river, that thenatives are obliged to cut a passage through them for theircanoes; still, notwithstanding the apparently unwholesomenature of the locality, it is seldom that the crews of vessels atanchor near the land, or running slowly along it, suffer any

inconvenience from its ii-,4&1)liitic exhalations."—pp. 16,17.Whydah, the first great slave mart in the bight of Benin,

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is apparently strongly defended by the Volta, and by ex-tensive marshes, the stirring up of whose waters causes theevolution of most offensive gases. Lagos, another slave mart,is defended by the sea, and by Lake Crada. The Benin isbounded by a succession of extensive mangrove swamps.The bight of Biafra, the most important and most covetedstation of the squadron, is, at the same time, the most un-healthy. The reason why it is most desired, is the greaterchance there exists of making prizes of slavers. All the riverswhich constitute the disemboguing branches of the Niger,empty themselves into it. The coast consists of almost inter-minable morasses; Princes’ Island, which is figurativelydescribed as an oasis in the desert, has rarely been productiveof fever, unless the sufferer have been predisposed thereto, byexposure, over-exertion, or intemperance. Clarence Cove, onthe north end of Fernando Po, is infinitely more unhealthy.Fernando Po is described as a most beautiful island, veryfertile, and almost, if not entirely, free from marsh; still thereis not, perhaps, any spot in the whole known world moredetrimental to health. Anna Bona, also, although destitute ofswamp land, there is every reason to believe, abounds in all ’’,,the principles essential to the production of remittent fever.Loango, the River Congo, Ambriz, and St. Paul de Loanda,are all localities in which fever is endemic. At the latter

place, Dr. Bryson states that "small-pox is rare, but all

attempts at vaccination, made with lymph brought in her-metically-sealed tubes, have failed." Benguela is consideredto be the most sickly of the Portuguese African coloniessouth of the Equator; it is situated on an alluvial flat. Old

Benguela is the most fertile and park-like land on this part ofthe station. Little Fish Bay, or Massamedes, possesses readyadvantages for the refitting of cruisers, and its climate is

thought, by the Portuguese, to be healthy. The traders,however, who travel inland, in search of ivory, gum, and wax,suffer severely from fever, and consequent enlargement of thespleen. The appearance of the country altogether, with theexception of the watering place, is that of a sandy desert.From this slight sketch of the coast of Africa, the dangers

that there attend the crews of her Majesty’s ships, and ofmerchantmen, may be readily surmised.The principal disease to be dreaded by the cruisers on the

coast is remittent fever; it prevails throughout the whole lineof coast at all times and seasons of the year, as an endemic,and at distant and uncertain periods it occasionally assumes anepidemic form. It is stated by our author to have seldompresented malignant characters, although when the crews ofvessels which have been long at anchor in any port or riverof the station have had communication with the shore, orhave been detached upon distant boat service, it has fre-

quently become virulent, and in a few instances appears tohave acquired contagious properties. The principal occasionswhen the disease showed malignant characters, and even pre-sented decided symptoms of yellow fever, are the epidemicof 1823, at Sierra Leone and on board the "Bann;" the en-demic fever in the "Sybille," in 1829; in the " Eden," in 1828and 1829; the epidemic at Fernando Po, in 1829; the endemic,in the " Bonetta," 11 Forester," and " Waterwitch," in 1838;and at the Island of Ascension, in the same year; in the"Buzzard," in 1839-40; in the "Wanderer," in 1841; the

"Hydra," in 1843; the " Growler" steamer, in 1844-45; the Styx," in 1845; and lastly, the " Eclair," in the same year.The essential causes of fever on the African station are as

yet unknown: marsh miasm has been assumed to be the prin-cipal agent in its production; and the nature of the soil, withthe extensive lagoons and mangrove-covered swamps, wouldtend to support this view. But still there are localities inwhich fever is rife, where none of these circumstances obtain.An arid, rocky soil, devoid of bush and swamp, has been notunfrequently the seat of a fever as malignant in its charactersas any that has occurred in the neighbourhood of the swamps,while certain swampy districts are entirely or comparatively

healthy. The predisposing and exciting causes are, however,more readily discovered. Dr. Bryson avers that there isnot any spot on the whole coast, within the tropics, whetherupon the main land or the adjacent islands, that is not

highly prejudicial to the health of Europeans; but he adds,that the greatest amount of sickness, and at least four-fifths ofthe mortality, have been caused by unnecessary exposure tothe fever-exciting agencies, the liability to which is greatlyincreased by immoderate indulgence in intoxication, by pro-tracted boat-service in the rivers on the station, a foul stateof the holds, and also by all causes which may induce impair-ment of the physical powers of the body, such as the depress-ing passions, over-exertion, together with a long continuanceon salt provisions. It has been already stated that prize crewsare specially liable to this fever.The influence of boat-service in the rivers on the coast,

in inducing attacks of fever, is much dwelt on by Dr. Bryson.Every page almost may be said to teem with examples, someof which are remarkably striking. The practice was at onetime abandoned, and its resumption does not speak in favourof the wisdom of the authorities. It has, on almost everyoccasion, been the cause of serious and frequently fatal inva-sions of disease.

" When boats are detached to lie in wait for slave vessels, orto seek them out in the branches and creeks of navigable rivers,they are manned, armed, and provisioned, according to theexigency of the case. If it be intended that they should beabsent for more than a few days, and without the prospect oflanding, they are furnished with a small cooking apparatus,which, however, is as frequently dispensed with as possible; foralthough it does not occupy much room in the boat, it is in-convenient, while the heat and smoke arising from it when inoperation materially add to the discomfort of all on board. If,on the other hand, it be intended that their absence should notexceed a few days, provisions ready cooked may be taken withthem. In either case, however, the mode of living is materiallydifferent from that on board ship. The same regularity canhardly be observed; the cooking is often indifferent, and fre-quently dispensed with altogether; the ration of salt pork, forinstance, has sometimes from choice been eaten raw, as it camefrom the brine; while, from a want of water, oras an indulgence,the allowance of rum is not unfrequently drunk in an undilutedstate. These and other similar matters may seem trifling indetail, but they are not so in the aggregate; independent of themore adverse climatorial agencies, they produce too frequentlysuch functional derangement as tends to the general dete.

rioration of health, and consequently, sooner or later, to theinduction of organic disease.

"Blanket dresses are invariably worn at night, and not un-frequently both night and day, as experience has proved themto be more safe and more comfortable than any other speciesof clothing. They are by no means so warm as might besupposed; while, by their absorbent nature, they speedily ridthe skin of its superabundant moisture, which from their opentexture is freely permitted to escape by evaporation withoutcooling the surface below what is compatible with health.During wet weather, when at anchor, the awning, if the boatbe furnished with one, is sloped, and in a calm it throws offthe rain tolerably well; but if there be wind, it is of little orno avail. All hands being then exposed to wet, their plightbecomes truly miserable, particularly during the night, whenthey are compelled to sleep packed closely together in thebottom of the boat, damp.perhaps cold, and at all events com-fortless ; while,if lying at anchor outside the bar of a riverorata short distance from the land, they may be still further incom-moded by the boat rolling ’gunwales under,’ in the heavy swellthat constantly sets in upon the shore. Few, therefore, as mightbe expected, return from expeditions on which these severeprivations have been experienced, without suffering moreor less in health. In some, this is manifested by catarrhal,rheumatic, and bowel complaints, or by a general sense ofsoreness over the whole body, as if from a severe beating,together with a feeling of lassitude and mental dejection, allof which, however, may give place, in a vigorous constitution,to returning health; while in others fever is the immediateand direct result: and although in these instances the majoritymay survive the violence of the primary attack, still the pro-bability is, from the nature of the exposure, that the diseasewill linger long with them in the form of irregular intermittent,until their health becomes so completely undermined as to

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demand their removal from the climate, otherwise they willgradually assume a bloated, unwholesome appearance fromenlargement of the spleen, or of the liver, together with dys-peptic ailments and a tendency to general dropsy, untilat last they sink, fairly worn out by the repeated attacks ofthe disease."The health of men employed on boat service is also much

influenced by the nature of the locality in which they may beexposed. Rivers with wide and almost imperceptibly slopingbanks, upon which the dwarf mangrove is abundant, are muchmore insalubrious than the open sea, although the exposure inthe latter be in the immediate neighbourhood of extensiveswamps, as along the entire coast of the bight of Benin; of theformer, none seems to exert a more baneful influence uponhealth than the Pongos, Nunez, Sherbro, or Seabar, and theGallinas, on the northern division of the station, although theMelacoorie, the Scarcies, and the Sierra Leone rivers, havealso proved equally destructive to health. The deadly nature ofthe whole of the mouths of the Niger, from the Benin to thesouthernmost creek of the Old Calebarto-ether with the Came-roons, is so well known as hardly to require notice here. Therivers to the south of the equator have not been so frequentlyexplored by the cruisers, unless, perhaps, within the last fewyears, as those to the north; their influence on the health ofthe squadron is not, therefore, so well understood; but it wouldappear they also abound in swamp emanation, and in all theother commonly acknowledged causes that give rise to re-mittent fevers, although it seems that they have less fre-quently assumed the malignant form peculiar to those con-tracted on the opposite side of the equator: this, nevertheless,may depend entirely upon accidental circumstances, as feverof a very violent character has been known to assail casualvisitors in the Congo since the time of Captain Tuckey’s expedi-tion, and has lately shown itself on board several of the cruisers,as well as amongst boats’ crews, when they have remainedthere for a few days at a time. Loango also possesses a feversoil. The Gaboon, on the other hand, although much nearerthe equator, is considered to be more healthy; but this, withthe experience we have, is not to be relied on.

‘‘It is also obvious that the nearer boats approach the shore,the greater the risk of contracting disease; this, again, is muchincreased by landing, and still more so by sleeping on shore,whether on dry or marsh ground—whether in the bush or outof it-under cover, or without cover: such imprudences aregenerally followed by fever of a most virulent and dangerouscharacter." The time occupied upon boat expeditions has varied from

one day to thirty, or even forty. A curious circumstance hasbeen observed in men who have been away so long as thelast-mentioned periods-namely, that when they returned andreached the deck of their own vessel, they have been seen toreel and stagger, as if they were under the influence of spirits,from weakness, giddiness, and loss of balance in the musclesof the limbs, affording unequivocal proof of the severity of theservice. The boats, moreover, when long absent, have some-times become so sodden with water, and their bottoms socovered with sea-weed, that they have been with greatdifficulty dragged through the water by their exhaustedcrews."-pp. 200-204.Many examples, illustrative of the dangerous consequences

resulting from boats’ crews ascending rivers, and being de-tained there during the night, or for several nights, might beadduced from the pages of this Report; but we conceive thatthe foregoing general remarks will be all that are necessaryto set the question in its proper light. Boat-service in therivers is not only dangerous on its own account, but alsobecause it includes all the causes of fever-to wit, insolation,night-exposure, intemperance, over-exertion, and the influenceof the depressing passions. It needs but a moment’s thoughtto show in what way all these causes may be combined withthat of boat-service in the rivers in inducing disease, nor canthere exist a doubt as to the severity of the attack, whenresulting from the combined effects of so many predisposingcauses. Boat-service has, in fact, been repeatedly the causeof remittent fever of a peculiarly malignant type.

Prize crews are stated by Dr. Bryson, for reasons alreadyalleged, to be peculiarly subject to fever; but this remarkappears to apply principally to those who convey their prizesto Sierra Leone. " They generally arrive, worn out by ex-cessive labour, broken rest, and exposure, both by night and

day, on the deck of a small vessel, probably crowded withslaves, in a loathsome state of misery and disease." When

landed, the crew take up their residence in a building appro-priated for their reception, called the barn; and being freed,in a great measure, from the control of their officers, plungeinto every kind of excess—the consequence being, a severeinvasion of fever, affecting them either while still at SierraLeone, or else soon after embarkation on board ship. At St.

Helena, it appears, where prizes are also now sent for adjudi-cation, the crews are landed without the slightest risk of con-tracting any serious ailment. The danger of the occurrenceof fever among prize-crews, after landing, arises from theirown excesses and carelessness, in recklessly exposing them-selves to the influence of the causes which have been so

repeatedly shown to be capable of generating that disease.As a means of prevention, the Conflict" gun-brig, roofedover, was moored in the river, for the reception of prize-crews ; but they could not be prevented going on shore, andalso committed many irregularities on board. "The vessel,at the same time, appeared to have acquired within herselfthe power of generating disease. The same was observed tohave occurred in the " Magninficent," moored in the harbourof Port Royal, in Jamaica, and it is believed to the " Serapis"before her. The " Grampus" hospital-ship in the Thames,at one time, seemed to have acquired similar properties, orto have become impregnated with some principle obnoxiousto health."The other causes, nature, symptoms, and treatment of the

fever, with the means of prevention, will be considered on afuture occasion.

Medical Societies.

ROYAL MEDICAL AND CHIRURGICAL SOCIETY.

JUNE 29.—J. M. ARNOTT, ESQ., F.R.S., PRESIDENT.

FATAL CASE OF DYSPHAGIA, PRODUCED BY A POLYPOUS GROWTHIN THE ŒSOPHAGUS. By R. ARROWSMITH, M.D., Senior Phy-sician to the Coventry and Warwickshire Hospital.

THE patient, a ribbon-weaver, aged forty-eight, not previouslyunhealthy, came under the author’s observation at the Hos-pital, in March last, having much difficulty of swallowing, withfrequent, and, at times, severe cough, (always excited by at-tempts to swallow, but occurring independently of them;)copious frothy expectoration; fever, but no dyspncea. The

dysphagia gradually increased until deglutition became nearlyimpossible. Attempts were made to pass a tube into theoesophagus, but without success, and they occasioned at thetime so much spasm of the glottis, as to endanger life. It oc-curred to the author, that if tracheotomy were performed,respiration might be carried on through a tube left in thetrachea, while more persevering attempts were made to passinstruments into the oesophagus. This operation was there-fore performed, and a tube left in the trachea. After this,the attempts to pass a tube proved equally unavailing, thoughthe power of swallowing was improved for a few days. Thedysphagia, however, shortly increased, and death ensued onthe 14th of May, purely from inanition, about fourteen weeksfrom the apparent commencement of the disease. On exami-nation after death, a polypous growth was discovered at thecommencement of the oesophagus immediately behind theglottis; it was rather larger than a walnut, and attached by ashort fibrous base, commencing about half an inch from theposterior commissure of the glottis, and extending for thesame distance in a straight line in the axis of the oesophagus.The tumour formed, on the one hand, a mechanical obstacleto the perviousness of the oesophagus, and on the other, bypassing under the epiglottis during attempts to swallow, pre-vented the closure of the glottis, and thus allowed fluids topass down the trachea. The author, in conclusion, refers tovarious writers who have related cases of polypus in the œso-

phagus, but remarks that the one now recorded, differs fromany he has seen referred to, in the dysphagia being complicatedwith, and greatly increased by, the tendency of food to passinto the glottis.